Provider Demographics
NPI:1477885119
Name:KRENN, CHERYL MANN (RPH)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:MANN
Last Name:KRENN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 DOVER DR
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-9720
Mailing Address - Country:US
Mailing Address - Phone:518-439-8252
Mailing Address - Fax:518-439-8252
Practice Address - Street 1:12 JUPITER LN
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-6918
Practice Address - Country:US
Practice Address - Phone:518-689-2900
Practice Address - Fax:518-689-2946
Is Sole Proprietor?:No
Enumeration Date:2010-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0318191835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist