Provider Demographics
NPI:1497168454
Name:HIPPENSTEAL, KALEY
Entity Type:Individual
Prefix:
First Name:KALEY
Middle Name:
Last Name:HIPPENSTEAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1131 N WAHNETA ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18109-8730
Mailing Address - Country:US
Mailing Address - Phone:610-504-9416
Mailing Address - Fax:
Practice Address - Street 1:450 BLUE VALLEY DR
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:PA
Practice Address - Zip Code:18013-1525
Practice Address - Country:US
Practice Address - Phone:610-863-6101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-07
Last Update Date:2014-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP446957183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist