Provider Demographics
NPI:1851541213
Name:KAPLAN, KENNETH J (RPH)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:J
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 JERUSALEM AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-1827
Mailing Address - Country:US
Mailing Address - Phone:516-826-0057
Mailing Address - Fax:516-826-8037
Practice Address - Street 1:2450 JERUSALEM AVE
Practice Address - Street 2:
Practice Address - City:NORTH BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-1827
Practice Address - Country:US
Practice Address - Phone:516-826-0057
Practice Address - Fax:516-826-8037
Is Sole Proprietor?:No
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY36108183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02319304Medicaid