Provider Demographics
NPI:1841474392
Name:HARBISON, KEVIN ANDREW (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:ANDREW
Last Name:HARBISON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 AIRBORNE PKWY
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-1434
Mailing Address - Country:US
Mailing Address - Phone:716-630-8601
Mailing Address - Fax:716-630-8456
Practice Address - Street 1:650 AIRBORNE PKWY
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-1434
Practice Address - Country:US
Practice Address - Phone:716-630-8601
Practice Address - Fax:716-630-8456
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03440562183500000X
PARP456072183500000X
MD27890183500000X
NY051137183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD27890OtherSTATE LICENSE NUMBER
PARP456072OtherSTATE LICENSE NUMBER
OH03440562OtherSTATE LICENSE NUMBER
NY051137OtherSTATE LICENSE NUMBER