Provider Demographics
NPI:1396057865
Name:BICKLEY, KATIE LOUISE (PHARMD)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:LOUISE
Last Name:BICKLEY
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 1:298 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-1850
Mailing Address - Country:US
Mailing Address - Phone:212-777-0740
Mailing Address - Fax:212-777-0747
Practice Address - Street 1:298 1ST AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-1850
Practice Address - Country:US
Practice Address - Phone:212-777-0740
Practice Address - Fax:212-777-0747
Is Sole Proprietor?:No
Enumeration Date:2010-07-12
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054616183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist