Most Relevant Information
Provider Data
| NPI Number: | 1003418864 |
| Provider Name: | KIMBERLEE SUE AUTH RPH |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 051.286990 |
Most Important Dates
| Enumeration Date: | 11/16/2020 |
| Last Updated: | 11/16/2020 |
Provider Practice Location
1569 1ST AVE
NEW YORK
NY
100284003
Practice Location Phone/Fax
| Phone: | 2122495198 |
| Fax: |
Provider Mailing Location
317 E 89TH ST APT 1E
NEW YORK
NY
101285073
Provider Mailing Phone/Fax
| Phone: | 3098301837 |
| Fax: |