Provider Demographics
NPI:1093200388
Name:KILADA, GEORGE (PHARMD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:
Last Name:KILADA
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 1:1340 63RD ST FL 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-5319
Mailing Address - Country:US
Mailing Address - Phone:646-625-9528
Mailing Address - Fax:
Practice Address - Street 1:5924 13TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-4934
Practice Address - Country:US
Practice Address - Phone:718-283-7233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-28
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY063626183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist