Healthcare Provider Details

I. General information

NPI: 1891022679
Provider Name (Legal Business Name): KRISTEN AF ARNOLD BS, PHARM D, CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2009
Last Update Date: 01/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

196 NORTH ST
GENEVA NY
14456-9709
US

IV. Provider business mailing address

2190 DUTCH HOLLOW RD
AVON NY
14414-9709
US

V. Phone/Fax

Practice location:
  • Phone: 585-747-2642
  • Fax:
Mailing address:
  • Phone: 585-226-3543
  • Fax: 585-226-1334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number040678
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number2142-0008
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: