Healthcare Provider Details

I. General information

NPI: 1437068947
Provider Name (Legal Business Name): KAITLYN O'PRANDY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 JACK MARTIN BLVD
BRICK NJ
08724-7732
US

IV. Provider business mailing address

86 BERNICE DR
FREEHOLD NJ
07728-1564
US

V. Phone/Fax

Practice location:
  • Phone: 732-836-4276
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number28RI03678600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: