Provider Demographics
NPI:1639274806
Name:REDDER, KATHERINE NOREEN (RPH)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:NOREEN
Last Name:REDDER
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:ROUTE 9D
Mailing Address - Street 2:
Mailing Address - City:CASTLE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:12511-5000
Mailing Address - Country:US
Mailing Address - Phone:845-831-2000
Mailing Address - Fax:845-838-5189
Practice Address - Street 1:196 WILLOW TREE RD
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:NY
Practice Address - Zip Code:12547-5308
Practice Address - Country:US
Practice Address - Phone:845-795-5301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8606183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist