Provider Demographics
NPI:1437757580
Name:NACCARATO, KAELA MARIE (PHARM D)
Entity Type:Individual
Prefix:
First Name:KAELA
Middle Name:MARIE
Last Name:NACCARATO
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 TEETSEL RD
Mailing Address - Street 2:
Mailing Address - City:SAUGERTIES
Mailing Address - State:NY
Mailing Address - Zip Code:12477-4130
Mailing Address - Country:US
Mailing Address - Phone:845-594-1435
Mailing Address - Fax:
Practice Address - Street 1:116 TEETSEL RD
Practice Address - Street 2:
Practice Address - City:SAUGERTIES
Practice Address - State:NY
Practice Address - Zip Code:12477-4130
Practice Address - Country:US
Practice Address - Phone:845-594-1435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY067231183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist