Provider Demographics
NPI:1114630944
Name:KITCHER, THEODORA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:THEODORA
Middle Name:
Last Name:KITCHER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 N 3RD AVE APT 6T
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-1378
Mailing Address - Country:US
Mailing Address - Phone:914-699-8591
Mailing Address - Fax:
Practice Address - Street 1:111 N 3RD AVE APT 6T
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-1378
Practice Address - Country:US
Practice Address - Phone:914-699-8591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-26
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044322183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist