MEDICARE: DR. KRISTEN AF ARNOLD BS, PHARM D, CDE

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
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	040678	NY
2	174H00000X	Health Educator	2142-0008	IL

General Provider Information

NPI Number	:	1891022679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTEN AF ARNOLD BS, PHARM D, CDE

Provider Business Mailing Address
First Line	:	2190 DUTCH HOLLOW RD
Second Line	:
City	:	AVON
State	:	NY
Zip	:	14414-9709
Country	:	US
Telephone Number	:	585-226-3543
Fax Number	:	585-226-1334

Provider Business Practice Location Address
First Line	:	196 NORTH ST
Second Line	:
City	:	GENEVA
State	:	NY
Zip	:	14456-9709
Country	:	US
Telephone Number	:	585-747-2642
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2009
Last Update Date	:	01/10/2015

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