Provider Demographics
NPI:1063968378
Name:HINNERS, KRISTINE MARIE (PHARMD)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:MARIE
Last Name:HINNERS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2724 166TH ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-1124
Mailing Address - Country:US
Mailing Address - Phone:347-886-1069
Mailing Address - Fax:
Practice Address - Street 1:603 UNIONDALE AVE
Practice Address - Street 2:
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11553-2637
Practice Address - Country:US
Practice Address - Phone:516-481-4825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-27
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY062271183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist