Provider Demographics
NPI:1174203533
Name:RANK, KERRIE A (MASTERS)
Entity type:Individual
Prefix:MS
First Name:KERRIE
Middle Name:A
Last Name:RANK
Suffix:
Gender:F
Credentials:MASTERS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 WOODMERE PL
Mailing Address - Street 2:
Mailing Address - City:SELDEN
Mailing Address - State:NY
Mailing Address - Zip Code:11784-3045
Mailing Address - Country:US
Mailing Address - Phone:631-767-6709
Mailing Address - Fax:
Practice Address - Street 1:18 WOODMERE PL
Practice Address - Street 2:
Practice Address - City:SELDEN
Practice Address - State:NY
Practice Address - Zip Code:11784-3045
Practice Address - Country:US
Practice Address - Phone:631-767-6709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist