Provider Demographics
NPI:1639359896
Name:POKIGO, KATHY ANN (RPH)
Entity type:Individual
Prefix:
First Name:KATHY ANN
Middle Name:
Last Name:POKIGO
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 1:5865 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1127
Mailing Address - Country:US
Mailing Address - Phone:716-675-7828
Mailing Address - Fax:716-882-3400
Practice Address - Street 1:424 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14222-2210
Practice Address - Country:US
Practice Address - Phone:716-882-3111
Practice Address - Fax:716-882-3400
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-05
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037080183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist