Basic Information
| Provider Information | |||||||||
| NPI: | 1063968378 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HINNERS | ||||||||
| FirstName: | KRISTINE | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | PHARM.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2724 166TH ST | ||||||||
| Address2: | |||||||||
| City: | FLUSHING | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113581124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3478861069 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 603 UNIONDALE AVE | ||||||||
| Address2: | |||||||||
| City: | UNIONDALE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115532637 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5164814825 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/27/2016 | ||||||||
| LastUpdateDate: | 01/23/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 062271 | NY | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.