Provider Demographics
NPI:1508497330
Name:KINAYA, MARCELLA KATARINA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARCELLA
Middle Name:KATARINA
Last Name:KINAYA
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 1:46960 VAN DYKE AVE
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48317-4378
Mailing Address - Country:US
Mailing Address - Phone:586-726-9220
Mailing Address - Fax:
Practice Address - Street 1:46960 VAN DYKE AVE
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48317-4378
Practice Address - Country:US
Practice Address - Phone:586-726-9220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302042606183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist