Healthcare Provider Details

I. General information

NPI: 1194640227
Provider Name (Legal Business Name): KIMBERLY NEWKIRK SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 GROFF RD
MONROEVILLE NJ
08343-1827
US

IV. Provider business mailing address

24 GROFF RD
MONROEVILLE NJ
08343-1827
US

V. Phone/Fax

Practice location:
  • Phone: 856-906-0284
  • Fax:
Mailing address:
  • Phone: 856-906-0284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02712500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: