Healthcare Provider Details

I. General information

NPI: 1134222078
Provider Name (Legal Business Name): MATTHEW STEPHEN KRUSZEWSKI BS, PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VA PITTSBURGH HEALTHCARE SYSTEM UNIVERSITY DRIVE C (132-MU)
PITTSBURGH PA
15240
US

IV. Provider business mailing address

6043 BOXER DR
BETHEL PARK PA
15102-3211
US

V. Phone/Fax

Practice location:
  • Phone: 412-688-6220
  • Fax:
Mailing address:
  • Phone: 412-851-1829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberRP041127L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: