Provider Demographics
NPI:1548583586
Name:KRUSZEWSKI, KEVIN M (BS PHARMACY)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:M
Last Name:KRUSZEWSKI
Suffix:
Gender:M
Credentials:BS PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5741 BUFFALO RD
Mailing Address - Street 2:
Mailing Address - City:HARBORCREEK
Mailing Address - State:PA
Mailing Address - Zip Code:16421-1626
Mailing Address - Country:US
Mailing Address - Phone:814-899-6280
Mailing Address - Fax:814-899-6266
Practice Address - Street 1:5741 BUFFALO RD
Practice Address - Street 2:
Practice Address - City:HARBORCREEK
Practice Address - State:PA
Practice Address - Zip Code:16421-1626
Practice Address - Country:US
Practice Address - Phone:814-899-6280
Practice Address - Fax:814-899-6266
Is Sole Proprietor?:No
Enumeration Date:2010-03-04
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP040105L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist