Provider Demographics
NPI:1174819973
Name:SAROSKY, KIMBERLY (PHARMD, BCPS)
Entity Type:Individual
Prefix:PROF
First Name:KIMBERLY
Middle Name:
Last Name:SAROSKY
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 RIVER ROAD
Mailing Address - Street 2:APT. 17G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10044
Mailing Address - Country:US
Mailing Address - Phone:570-401-0609
Mailing Address - Fax:
Practice Address - Street 1:1111 AMSTERDAM AVE.
Practice Address - Street 2:DEPARTMENT OF PHARMACY BABCOCK BUILDING 2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025
Practice Address - Country:US
Practice Address - Phone:212-523-3883
Practice Address - Fax:212-523-5703
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0532661835P0018X
NY31008811835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy