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NPI Code Detail

MEDICARE: DR. CATHERINE IRENE KOVACIK PHARM. D.

MEDICARE:  DR. CATHERINE IRENE KOVACIK  PHARM. D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist050461NY

General Provider Information

NPI Number : 1679762231
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CATHERINE IRENE KOVACIK PHARM. D.
Provider Business Mailing Address
First Line : 135 FAIRGROUNDS MEMORIAL PKWY
Second Line :
City : ITHACA
State : NY
Zip : 14850-5362
Country : US
Telephone Number : 607-277-8126
Fax Number : 607-277-8613
Provider Business Practice Location Address
First Line : 135 FAIRGROUNDS MEMORIAL PKWY
Second Line :
City : ITHACA
State : NY
Zip : 14850-5362
Country : US
Telephone Number : 72-778-1266
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2007
Last Update Date : 07/25/2023

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