Provider Demographics
NPI:1235309121
Name:KIPERMAN, JANE (PHARMD, RPH)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:
Last Name:KIPERMAN
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2955 SHELL RD APT 8B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-3651
Mailing Address - Country:US
Mailing Address - Phone:347-834-3138
Mailing Address - Fax:
Practice Address - Street 1:630 FOREST AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310-2516
Practice Address - Country:US
Practice Address - Phone:718-727-6558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050781183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist