Provider Demographics
NPI:1265507214
Name:KRACHMAN, DONALD (DO)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:
Last Name:KRACHMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 S WHITE HORSE PIKE STE D1
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-2029
Mailing Address - Country:US
Mailing Address - Phone:609-561-0033
Mailing Address - Fax:609-561-2748
Practice Address - Street 1:777 S WHITE HORSE PIKE STE D1
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-2029
Practice Address - Country:US
Practice Address - Phone:609-561-0033
Practice Address - Fax:609-561-2748
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB02889900207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE51886Medicare UPIN