Provider Demographics
NPI:1285391672
Name:MARICICH, KATE EMILY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KATE
Middle Name:EMILY
Last Name:MARICICH
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 1:568 BEECH AVE
Mailing Address - Street 2:
Mailing Address - City:SADDLE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07663-4428
Mailing Address - Country:US
Mailing Address - Phone:201-452-7040
Mailing Address - Fax:
Practice Address - Street 1:568 BEECH AVE
Practice Address - Street 2:
Practice Address - City:SADDLE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07663-4428
Practice Address - Country:US
Practice Address - Phone:201-452-7040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-20
Last Update Date:2021-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04221600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist