Provider Demographics
NPI:1164042248
Name:RIDEN, KATHERINE ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ANN
Last Name:RIDEN
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 1:1842 PARKVIEW BLVD APT 301
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-5203
Mailing Address - Country:US
Mailing Address - Phone:772-480-2523
Mailing Address - Fax:
Practice Address - Street 1:335 SUTHERLAND DRIVE SALK PAVILION 222
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15261-6801
Practice Address - Country:US
Practice Address - Phone:412-624-5240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-20
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS59923183500000X
PARP454769183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist