Provider Demographics
NPI:1861574907
Name:PIGULA, KATHY JEAN (RPH)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:JEAN
Last Name:PIGULA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 WENLOCK RD
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-3072
Mailing Address - Country:US
Mailing Address - Phone:585-223-0904
Mailing Address - Fax:
Practice Address - Street 1:777 CLINTON AVE S
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-1401
Practice Address - Country:US
Practice Address - Phone:585-279-4790
Practice Address - Fax:585-242-7355
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031813-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist