Provider Demographics
NPI:1194991711
Name:LOK, KIMBERLY YUEN KAN (PHARMD)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:YUEN KAN
Last Name:LOK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:YUEN KAN
Other - Middle Name:
Other - Last Name:LOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:46 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-5504
Mailing Address - Country:US
Mailing Address - Phone:212-475-3563
Mailing Address - Fax:212-475-6327
Practice Address - Street 1:46 3RD AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-5504
Practice Address - Country:US
Practice Address - Phone:212-475-3563
Practice Address - Fax:212-475-6327
Is Sole Proprietor?:No
Enumeration Date:2008-05-03
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052333183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02870331Medicaid