Provider Demographics
NPI:1689890220
Name:BRAUEN, KATHLEEN ALICE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:ALICE
Last Name:BRAUEN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4220 ORANGEPORT RD
Mailing Address - Street 2:
Mailing Address - City:GASPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14067-9251
Mailing Address - Country:US
Mailing Address - Phone:716-289-4055
Mailing Address - Fax:
Practice Address - Street 1:200 OHIO ST
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:NY
Practice Address - Zip Code:14103-1063
Practice Address - Country:US
Practice Address - Phone:585-798-2000
Practice Address - Fax:585-798-8066
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048652183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist