Provider Demographics
NPI:1568760171
Name:KRAFT, ROBERT LEE (DO, RPH)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LEE
Last Name:KRAFT
Suffix:
Gender:M
Credentials:DO, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2085 RT 5&20
Mailing Address - Street 2:
Mailing Address - City:SENECA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:13148
Mailing Address - Country:US
Mailing Address - Phone:315-568-4300
Mailing Address - Fax:315-781-9086
Practice Address - Street 1:2085 RT 5&20
Practice Address - Street 2:
Practice Address - City:SENECA FALLS
Practice Address - State:NY
Practice Address - Zip Code:13148
Practice Address - Country:US
Practice Address - Phone:315-568-4300
Practice Address - Fax:315-568-1611
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-06
Last Update Date:2022-05-25
Deactivation Date:2020-08-13
Deactivation Code:
Reactivation Date:2020-08-26
Provider Licenses
StateLicense IDTaxonomies
NC13235183500000X
NY043074183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist