Provider Demographics
NPI:1538161799
Name:LERI, FREDERICK (PHARMD)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:
Last Name:LERI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 GREYSTONE DR
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN TOP
Mailing Address - State:PA
Mailing Address - Zip Code:18707-1282
Mailing Address - Country:US
Mailing Address - Phone:570-474-0635
Mailing Address - Fax:570-474-0649
Practice Address - Street 1:700 QUINCY AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-1724
Practice Address - Country:US
Practice Address - Phone:570-340-2270
Practice Address - Fax:570-340-2017
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP034395T1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy