Provider Demographics
NPI:1366764581
Name:MELITA, ALBERT J JR (REGISTERED PHARMACIS)
Entity type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:J
Last Name:MELITA
Suffix:JR
Gender:M
Credentials:REGISTERED PHARMACIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 FOREST GLEN DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14612-2276
Mailing Address - Country:US
Mailing Address - Phone:585-720-1671
Mailing Address - Fax:
Practice Address - Street 1:100 ELMRIDGE CENTER DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-3459
Practice Address - Country:US
Practice Address - Phone:585-227-1210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-16
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043444183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist