Provider Demographics
NPI:1992913024
Name:KOST, MEL M (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:MEL
Middle Name:M
Last Name:KOST
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7782 DRYER RD
Mailing Address - Street 2:
Mailing Address - City:VICTOR
Mailing Address - State:NY
Mailing Address - Zip Code:14564-9169
Mailing Address - Country:US
Mailing Address - Phone:585-924-2857
Mailing Address - Fax:
Practice Address - Street 1:345 EASTERN BLVD
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-2206
Practice Address - Country:US
Practice Address - Phone:585-394-1595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY20534183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist