Healthcare Provider Details

I. General information

NPI: 1285664433
Provider Name (Legal Business Name): LISA M KRAPF RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 10/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 FORT HILL AVE OUTPATIENT PHARMACY DEPT 119-B
CANANDAIGUA NY
14424-1159
US

IV. Provider business mailing address

400 FORT HILL AVE OUTPATIENT PHARMACY DEPT 119-B
CANANDAIGUA NY
14424-1159
US

V. Phone/Fax

Practice location:
  • Phone: 585-393-7610
  • Fax:
Mailing address:
  • Phone: 585-393-7610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number040582
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number040582
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: