| Doctor Name: | MR. FIDELE JOHN FANELLI |
| NPI Number: | 1083938294 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RPH |
| License Number: | 025484 |
| Business Practice Address: | 44 Genesee St New Hartford, NY - 134132337 |
| Business Phone Number: | 3157321615 |
| Business Fax Number: | 3157323604 |
| Mailing Address: | 3065 Mohawk St, SAUQUOIT |
| State: | NY |
| Postal Code: | 134562907 |
| Phone Number: | 3157371809 |
| Fax Number: | 3157371809 |
| NPI Enumeration Date: | 03/16/2010 |
| NPI Last Update Date: | 03/16/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1835P0018X |
| License Number: | 025484 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Pharmacy Service Providers |
| Taxonomy Classification: | Pharmacist |
| Taxonomy Specialization: | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Taxonomy Definition: | Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |