Provider Demographics
NPI:1780092858
Name:SGAMBATI, KIMBERLY (PHARMD)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:SGAMBATI
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 1:9400 SCOTT MOORE WAY
Mailing Address - Street 2:
Mailing Address - City:PERRY HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21128-8932
Mailing Address - Country:US
Mailing Address - Phone:410-529-3980
Mailing Address - Fax:410-529-5992
Practice Address - Street 1:9400 SCOTT MOORE WAY
Practice Address - Street 2:
Practice Address - City:PERRY HALL
Practice Address - State:MD
Practice Address - Zip Code:21128-8932
Practice Address - Country:US
Practice Address - Phone:410-529-3980
Practice Address - Fax:410-529-5992
Is Sole Proprietor?:No
Enumeration Date:2014-08-01
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19234183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist