Provider Demographics
NPI:1396012803
Name:ADAMOV, KATERYNA (PHARMD)
Entity Type:Individual
Prefix:
First Name:KATERYNA
Middle Name:
Last Name:ADAMOV
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 1:1452 BETHLEHEM PIKE
Mailing Address - Street 2:
Mailing Address - City:FLOURTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19031-2004
Mailing Address - Country:US
Mailing Address - Phone:215-836-0128
Mailing Address - Fax:215-836-0927
Practice Address - Street 1:1452 BETHLEHEM PIKE
Practice Address - Street 2:
Practice Address - City:FLOURTOWN
Practice Address - State:PA
Practice Address - Zip Code:19031-2004
Practice Address - Country:US
Practice Address - Phone:215-836-0128
Practice Address - Fax:215-836-0927
Is Sole Proprietor?:No
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP440171183500000X
PA21913818183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist