Kirstie Fung, PHARMD
Individual provider Active NPI Pharmacist · Chappaqua, NY
NPI 1972045532 · NPPES record last updated Nov 14, 2016
Key facts
- NPI
- 1972045532
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- I062320 (NY)
- Practice address
- 411 King St
Chappaqua, NY 10514-3543 - Phone
- (914) 861-9130
- Fax
- (914) 861-9247
- NPI assigned
- Nov 14, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I062320 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past |
Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | I062320 | NY | Yes |
Addresses
Primary practice location
411 King St
Chappaqua, NY 10514-3543
Mailing address
411 King St
Chappaqua, NY 10514-3543
Phone (914) 861-9130
Other providers in Chappaqua, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 14, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.