Provider Demographics
NPI:1700249257
Name:ZIEMBA, KRISTINE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTINE
Middle Name:
Last Name:ZIEMBA
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 1:7901 LANSDOWNE AVE
Mailing Address - Street 2:
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082-5424
Mailing Address - Country:US
Mailing Address - Phone:610-789-5628
Mailing Address - Fax:
Practice Address - Street 1:7901 LANSDOWNE AVE
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-5424
Practice Address - Country:US
Practice Address - Phone:610-789-5628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-01
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP444713183500000X
DEA1-0004584183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist