Healthcare Provider Details

I. General information

NPI: 1366373110
Provider Name (Legal Business Name): KRISTIN WILT-SENAVAITIS PHARMD
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GUTHRIE DR
CORNING NY
14830-2899
US

IV. Provider business mailing address

1 GUTHRIE DR
CORNING NY
14830-2899
US

V. Phone/Fax

Practice location:
  • Phone: 607-937-7284
  • Fax: 607-937-7867
Mailing address:
  • Phone: 607-937-7284
  • Fax: 607-937-7867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP445813
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number064793
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: