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General NPI Number Information
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NPI Number | 1295510733
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Entity Type | Individual
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Provider Name | KAITLYN E MARSHALL PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/30/2023
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Last Update Date | 08/30/2023
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Provider Practice Location Address
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Address Line | 130 MALCOLM X BLVD
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City | NEW YORK
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State | NY
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Zip | 10026-2503
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Country | US
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Telephone | 732-575-0274
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Fax |
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Provider Business Mailing Address
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Address Line | 329 E 89TH ST APT 3E
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City | NEW YORK
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State | NY
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Zip | 10128-7526
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Country | US
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Telephone | 732-575-0274
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 068329
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License Number State | NY
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