Most Relevant Information
Provider Data
| NPI Number: | 1003208125 |
| Provider Name: | KAYLEIGH BORNHAUSER PHARMD |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | I059161 |
Most Important Dates
| Enumeration Date: | 02/26/2015 |
| Last Updated: | 02/26/2015 |
Provider Practice Location
11 TRIEBLE AVE
BALLSTON SPA
NY
120206010
Practice Location Phone/Fax
| Phone: | 5188854672 |
| Fax: |
Provider Mailing Location
PO BOX 1000
MS 3000
PORTLAND
ME
041045005
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |