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General NPI Number Information
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NPI Number | 1619607132
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Entity Type | Individual
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Provider Name | NICHOLAS KURYLUK
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Gender | Male
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Dates
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Enumeration Date | 06/16/2022
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Last Update Date | 06/16/2022
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Provider Practice Location Address
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Address Line | 112 ATLANTIC AVE
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City | DINGMANS FERRY
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State | PA
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Zip | 18328-9801
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Country | US
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Telephone | 570-832-0294
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Fax |
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Provider Business Mailing Address
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Address Line | 140 HAY RD
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City | MILFORD
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State | PA
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Zip | 18337-9629
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Country | US
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Telephone | 570-955-7488
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number |
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License Number State |
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