Provider Demographics
NPI:1619498128
Name:KRAKOWSKI, ANNA (NP)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:KRAKOWSKI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:KRAKOWSKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:7137 70TH ST APT C
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11385-7245
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7137 70TH ST # C
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:NY
Practice Address - Zip Code:11385-7245
Practice Address - Country:US
Practice Address - Phone:718-781-8801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-05
Last Update Date:2017-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF308112363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care