Provider Demographics
NPI:1336289677
Name:MAIER, KIMBERLEY J (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLEY
Middle Name:J
Last Name:MAIER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7211 FISHER RD
Mailing Address - Street 2:
Mailing Address - City:OAKFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14125-9433
Mailing Address - Country:US
Mailing Address - Phone:585-948-8364
Mailing Address - Fax:
Practice Address - Street 1:6660 4TH SECTION RD
Practice Address - Street 2:
Practice Address - City:BROCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14420-2448
Practice Address - Country:US
Practice Address - Phone:585-637-6855
Practice Address - Fax:585-637-7848
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042340183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist