Provider Demographics
NPI:1548582745
Name:ZINERCO, KIMBERLEY (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLEY
Middle Name:
Last Name:ZINERCO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 HEMPSTEAD AVE
Mailing Address - Street 2:
Mailing Address - City:MALVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11565-2034
Mailing Address - Country:US
Mailing Address - Phone:516-593-8663
Mailing Address - Fax:516-599-8356
Practice Address - Street 1:247 HEMPSTEAD AVE
Practice Address - Street 2:
Practice Address - City:MALVERNE
Practice Address - State:NY
Practice Address - Zip Code:11565-2034
Practice Address - Country:US
Practice Address - Phone:516-593-8663
Practice Address - Fax:516-599-8356
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-16
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045507-1183500000X
FLPS41837183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist