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General NPI Number Information
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NPI Number | 1679774863
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Entity Type | Individual
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Provider Name | JILL KRABAK PHARMD, L.AC
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Gender | Female
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 03/14/2024
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Provider Practice Location Address
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Address Line | 73 MONTAGE MOUNTAIN RD
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City | MOOSIC
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State | PA
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Zip | 18507-1751
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Country | US
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Telephone | 570-630-4001
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Fax |
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Provider Business Mailing Address
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Address Line | 410 1/2 REAR FRONT ST
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City | JESSUP
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State | PA
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Zip | 18434-1946
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Country | US
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Telephone | 215-435-1109
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28R102820100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP045901L
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AK001230
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License Number State | PA
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