Provider Demographics
NPI:1073286191
Name:PHARMER, KERRY (CAT)
Entity Type:Individual
Prefix:
First Name:KERRY
Middle Name:
Last Name:PHARMER
Suffix:
Gender:F
Credentials:CAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 CLOVE VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:HIGH FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12440-5401
Mailing Address - Country:US
Mailing Address - Phone:845-541-8816
Mailing Address - Fax:
Practice Address - Street 1:50 CENTER ST
Practice Address - Street 2:
Practice Address - City:ELLENVILLE
Practice Address - State:NY
Practice Address - Zip Code:12428-1315
Practice Address - Country:US
Practice Address - Phone:845-647-3349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist