Provider Demographics
NPI:1043497852
Name:CUTLER, KENNETH HARVEY (RPH)
Entity type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:HARVEY
Last Name:CUTLER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 MAIN STREET
Mailing Address - Street 2:C/O CVS PHARMACY
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735
Mailing Address - Country:US
Mailing Address - Phone:516-694-6210
Mailing Address - Fax:516-694-7813
Practice Address - Street 1:335 MAIN ST
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-3508
Practice Address - Country:US
Practice Address - Phone:516-694-6210
Practice Address - Fax:516-694-7813
Is Sole Proprietor?:No
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029770183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist