Healthcare Provider Details

I. General information

NPI: 1770368722
Provider Name (Legal Business Name): KAYLA MARIE PAYACK PHARMD, RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2023
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 LEVITTOWN CTR
LEVITTOWN PA
19055-2601
US

IV. Provider business mailing address

850 N PENNSYLVANIA AVE
YARDLEY PA
19067-2022
US

V. Phone/Fax

Practice location:
  • Phone: 215-949-6605
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number32595
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP457838
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: