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General NPI Number Information
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NPI Number | 1467737809
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Entity Type | Individual
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Provider Name | BEATA KWIATKOWSKA PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/17/2011
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Last Update Date | 10/17/2011
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Provider Practice Location Address
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Address Line | 844 W FREMONT ST
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City | GALESBURG
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State | IL
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Zip | 61401-2509
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Country | US
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Telephone | 309-343-5141
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Fax |
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Provider Business Mailing Address
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Address Line | 574 MORGAN AVE APT 2R
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City | BROOKLYN
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State | NY
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Zip | 11222-4466
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Country | US
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Telephone |
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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 | 051.295323
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License Number State | IL
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