MEDICARE: MICHAEL JAN KRASNY PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	16093-40	WI

General Provider Information

NPI Number	:	1972818060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL JAN KRASNY PHARM.D.

Provider Business Mailing Address
First Line	:	444 E CORCORAN AVE
Second Line	:	#511
City	:	MILWAUKEE
State	:	WI
Zip	:	53202-6121
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	N77W14435 APPLETON AVE
Second Line	:
City	:	MENOMONEE FALLS
State	:	WI
Zip	:	53051-4306
Country	:	US
Telephone Number	:	262-255-8673
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2010
Last Update Date	:	08/12/2010

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