Provider Demographics
NPI:1841571775
Name:KUKIELKA, ELIZABETH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:KUKIELKA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:WINTERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 N BRADFORD AVENUE
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380
Mailing Address - Country:US
Mailing Address - Phone:610-696-0145
Mailing Address - Fax:610-696-0260
Practice Address - Street 1:300 N BRADFORD AVENUE
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380
Practice Address - Country:US
Practice Address - Phone:610-696-0145
Practice Address - Fax:610-696-0260
Is Sole Proprietor?:No
Enumeration Date:2011-09-06
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP442664183500000X
DEA1-0003786183500000X
MD20044183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist