Provider Demographics
NPI:1649728494
Name:SCHMIDT, KERILYNN
Entity type:Individual
Prefix:
First Name:KERILYNN
Middle Name:
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 ROUTE 179
Mailing Address - Street 2:
Mailing Address - City:LAMBERTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08530-3447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1509 ROUTE 179
Practice Address - Street 2:
Practice Address - City:LAMBERTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08530-3447
Practice Address - Country:US
Practice Address - Phone:609-397-8889
Practice Address - Fax:609-397-8383
Is Sole Proprietor?:No
Enumeration Date:2016-09-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP038756L183500000X
NJRI21990183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist