Provider Demographics
NPI:1649690678
Name:FERRER, KATHLYNN C (PHARMD)
Entity type:Individual
Prefix:
First Name:KATHLYNN
Middle Name:C
Last Name:FERRER
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 1:26 SURREY LN
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-3356
Mailing Address - Country:US
Mailing Address - Phone:201-403-7301
Mailing Address - Fax:
Practice Address - Street 1:815 E TREMONT AVE
Practice Address - Street 2:STORE #H
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-4108
Practice Address - Country:US
Practice Address - Phone:718-513-3210
Practice Address - Fax:718-513-3209
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-17
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058605183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist