Provider Demographics
NPI:1396891313
Name:KRISTELLER, JUDITH LYN (PHARMD, BCPS)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:LYN
Last Name:KRISTELLER
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1081 MEADOWCREST DR
Mailing Address - Street 2:
Mailing Address - City:SHAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18708-9707
Mailing Address - Country:US
Mailing Address - Phone:570-408-4272
Mailing Address - Fax:570-408-7729
Practice Address - Street 1:1081 MEADOWCREST DR
Practice Address - Street 2:
Practice Address - City:SHAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18708-9707
Practice Address - Country:US
Practice Address - Phone:570-408-4272
Practice Address - Fax:570-408-7729
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP4380401835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy