Provider Demographics
NPI:1932642832
Name:KITE, KRISTIN (RPH)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:KITE
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 1:727 RUBBER AVE
Mailing Address - Street 2:
Mailing Address - City:NAUGATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06770-3642
Mailing Address - Country:US
Mailing Address - Phone:203-723-6939
Mailing Address - Fax:
Practice Address - Street 1:727 RUBBER AVE
Practice Address - Street 2:
Practice Address - City:NAUGATUCK
Practice Address - State:CT
Practice Address - Zip Code:06770-3642
Practice Address - Country:US
Practice Address - Phone:203-723-6939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-23
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7649183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist