Provider Demographics
NPI:1679762231
Name:KOVACIK, CATHERINE IRENE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:IRENE
Last Name:KOVACIK
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:I
Other - Last Name:WINTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:135 FAIRGROUNDS MEMORIAL PKWY
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-5362
Mailing Address - Country:US
Mailing Address - Phone:607-277-8126
Mailing Address - Fax:607-277-8613
Practice Address - Street 1:135 FAIRGROUNDS MEMORIAL PKWY
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-5362
Practice Address - Country:US
Practice Address - Phone:072-778-1266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-19
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050461183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist