Provider Demographics
NPI:1750606224
Name:BRYANT, KATHLEEN (RPH)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:
Last Name:BRYANT
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 1:521 DUANESBURG RD
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12306-1054
Mailing Address - Country:US
Mailing Address - Phone:518-356-2968
Mailing Address - Fax:518-356-6978
Practice Address - Street 1:521 DUANESBURG RD
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12306-1054
Practice Address - Country:US
Practice Address - Phone:518-356-2968
Practice Address - Fax:518-356-6978
Is Sole Proprietor?:No
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYI033974-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist