=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740504463
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ADRIANA KRANJAC R.PH.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/24/2010
-----------------------------------------------------
Last Update Date | 01/10/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7575 31ST AVE
-----------------------------------------------------
City | EAST ELMHURST
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11370-1811
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-446-0300
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6120 GRAND CENTRAL PKWY APT C1105
-----------------------------------------------------
City | FOREST HILLS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11375-1246
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-202-7803
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 043780
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------