Provider Demographics
NPI:1609227792
Name:CHICHILITTI, KOURTNEY A (PHARMD)
Entity Type:Individual
Prefix:
First Name:KOURTNEY
Middle Name:A
Last Name:CHICHILITTI
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 1:415 ELM CIR
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-1927
Mailing Address - Country:US
Mailing Address - Phone:215-997-6734
Mailing Address - Fax:
Practice Address - Street 1:415 ELM CIR
Practice Address - Street 2:
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-1927
Practice Address - Country:US
Practice Address - Phone:215-997-6734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-29
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP440041183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist