Provider Demographics
NPI:1477737229
Name:KIERNAN, ANN (RPH)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:KIERNAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:
Other - Last Name:SPIEGEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:50 SPRING VALLEY MARKETPLACE
Mailing Address - Street 2:TARGET 1808
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-5213
Mailing Address - Country:US
Mailing Address - Phone:845-371-5811
Mailing Address - Fax:
Practice Address - Street 1:50 SPRING VALLEY MARKETPLACE
Practice Address - Street 2:TARGET 1808
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-5213
Practice Address - Country:US
Practice Address - Phone:845-371-5811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-27
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038753183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist