Provider Demographics
NPI:1366742439
Name:LI, KATHRYN MENG (PHARMD)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MENG
Last Name:LI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:MENG
Other - Middle Name:
Other - Last Name:LI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:927 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-8527
Mailing Address - Country:US
Mailing Address - Phone:301-695-2835
Mailing Address - Fax:301-695-2839
Practice Address - Street 1:927 W 7TH ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-8527
Practice Address - Country:US
Practice Address - Phone:301-695-2835
Practice Address - Fax:301-695-2839
Is Sole Proprietor?:No
Enumeration Date:2010-10-23
Last Update Date:2010-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19180183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist