Provider Demographics
NPI:1720725005
Name:HANRAHAN, KATHLEEN (PHARMD)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:HANRAHAN
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 1:171 SHAFER RD
Mailing Address - Street 2:
Mailing Address - City:CHENANGO FORKS
Mailing Address - State:NY
Mailing Address - Zip Code:13746-2112
Mailing Address - Country:US
Mailing Address - Phone:607-875-4218
Mailing Address - Fax:
Practice Address - Street 1:600 ROE AVE
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14905-1676
Practice Address - Country:US
Practice Address - Phone:607-737-4557
Practice Address - Fax:607-737-7767
Is Sole Proprietor?:No
Enumeration Date:2022-05-17
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP456900183500000X
NY099018I390200000X
NY0694631835I0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835I0206XPharmacy Service ProvidersPharmacistInfectious Diseases
No183500000XPharmacy Service ProvidersPharmacist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program