Provider Demographics
NPI:1326512351
Name:XIE, KIMBERLY (PHARMD)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:XIE
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 1:12 CARLEY CT
Mailing Address - Street 2:
Mailing Address - City:WEST NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10994-1738
Mailing Address - Country:US
Mailing Address - Phone:845-675-2653
Mailing Address - Fax:
Practice Address - Street 1:59 ROUTE 59
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-3536
Practice Address - Country:US
Practice Address - Phone:845-371-6464
Practice Address - Fax:845-213-4130
Is Sole Proprietor?:No
Enumeration Date:2019-01-12
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY064823183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist