Provider Demographics
NPI:1538020417
Name:KOVALESKI, KALLEY NICOLE (PHARMD)
Entity type:Individual
Prefix:
First Name:KALLEY
Middle Name:NICOLE
Last Name:KOVALESKI
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 1:1937 MACDADE BLVD
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:PA
Mailing Address - Zip Code:19033-1214
Mailing Address - Country:US
Mailing Address - Phone:610-237-1302
Mailing Address - Fax:
Practice Address - Street 1:1937 MACDADE BLVD
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:PA
Practice Address - Zip Code:19033-1214
Practice Address - Country:US
Practice Address - Phone:610-237-1302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-20
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP460023183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist