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NPI Code Detail

MEDICARE: DR. KATHLEEN ALICE BRAUEN PHARM D

MEDICARE: DR. KATHLEEN ALICE BRAUEN PHARM D
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
1183500000XPharmacist048652NY

General Provider Information

NPI Number : 1689890220
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATHLEEN ALICE BRAUEN PHARM D
Provider Business Mailing Address
First Line : 4220 ORANGEPORT RD
Second Line :
City : GASPORT
State : NY
Zip : 14067-9251
Country : US
Telephone Number : 716-289-4055
Fax Number :
Provider Business Practice Location Address
First Line : 200 OHIO ST
Second Line :
City : MEDINA
State : NY
Zip : 14103-1063
Country : US
Telephone Number : 585-798-2000
Fax Number : 585-798-8066
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2007
Last Update Date : 05/08/2018

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