MEDICARE: ANN KIERNAN RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	038753	NY

General Provider Information

NPI Number	:	1477737229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN KIERNAN RPH

Provider Business Mailing Address
First Line	:	50 SPRING VALLEY MARKETPLACE
Second Line	:	TARGET 1808
City	:	SPRING VALLEY
State	:	NY
Zip	:	10977-5213
Country	:	US
Telephone Number	:	845-371-5811
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 SPRING VALLEY MARKETPLACE
Second Line	:	TARGET 1808
City	:	SPRING VALLEY
State	:	NY
Zip	:	10977-5213
Country	:	US
Telephone Number	:	845-371-5811
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2007
Last Update Date	:	03/19/2013

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