Provider Demographics
NPI:1255920229
Name:KABARITI, VIVIAN (PHARMD)
Entity type:Individual
Prefix:
First Name:VIVIAN
Middle Name:
Last Name:KABARITI
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 1:2365 E 13TH ST APT 4E
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4361
Mailing Address - Country:US
Mailing Address - Phone:718-249-7878
Mailing Address - Fax:
Practice Address - Street 1:2934 AVENUE R
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-2603
Practice Address - Country:US
Practice Address - Phone:718-758-4800
Practice Address - Fax:718-758-4799
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-14
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04015200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist