Provider Demographics
NPI:1447292347
Name:CRISAFULLI, MELISSA CALABRO (RPH)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:CALABRO
Last Name:CRISAFULLI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 VASSAR ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-3345
Mailing Address - Country:US
Mailing Address - Phone:585-256-9939
Mailing Address - Fax:
Practice Address - Street 1:601 ELMWOOD AVE BOX 638
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-275-6272
Practice Address - Fax:585-276-0367
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047921183500000X
NC14432183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist