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Individual
MRS. KIM FANIZZA
Active
Individual
MRS. KIM FANIZZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
042720-1
NY
183500000X
Pharmacist
28R102325600
NJ
183500000X
Pharmacist
PS29107
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042720-1
RPH STATE LICENSE NUMBER
NY
01
—
28R102325600
RPH LICENSE NUMBER
NJ
01
—
PS29107
RPH LICENSE NUMBER
FL
Enumeration date
03/04/2008
Last updated
03/04/2008
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