Provider Demographics
NPI:1902135031
Name:HARROUN, KIMBERLY ANN (PHARMD)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN
Last Name:HARROUN
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 1:307 NOTTINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-3453
Mailing Address - Country:US
Mailing Address - Phone:315-214-5097
Mailing Address - Fax:315-314-6606
Practice Address - Street 1:307 NOTTINGHAM RD
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-3453
Practice Address - Country:US
Practice Address - Phone:315-214-5097
Practice Address - Fax:315-314-6606
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053573183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist