Provider Demographics
NPI:1275857161
Name:KOHLER, FREDERICK S (RPH)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:S
Last Name:KOHLER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 BRUCE DR
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-5142
Mailing Address - Country:US
Mailing Address - Phone:516-483-2060
Mailing Address - Fax:516-483-2060
Practice Address - Street 1:27005 76TH AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1402
Practice Address - Country:US
Practice Address - Phone:718-470-7430
Practice Address - Fax:718-343-8244
Is Sole Proprietor?:No
Enumeration Date:2010-03-21
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027495183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist