Provider Demographics
NPI:1942754478
Name:KISSINGER, SARA TERESE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:TERESE
Last Name:KISSINGER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 MERRITT PL
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-2020
Mailing Address - Country:US
Mailing Address - Phone:585-703-4710
Mailing Address - Fax:
Practice Address - Street 1:65 MERRITT PL
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-2020
Practice Address - Country:US
Practice Address - Phone:585-703-4710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-13
Last Update Date:2016-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY062125183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist