Provider Demographics
NPI:1679918023
Name:KRANIK, ROBERT (LPN)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:KRANIK
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 STATE ROUTE 42
Mailing Address - Street 2:
Mailing Address - City:FORESTBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12777-6541
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1660 STATE ROUTE 42
Practice Address - Street 2:
Practice Address - City:FORESTBURGH
Practice Address - State:NY
Practice Address - Zip Code:12777-6541
Practice Address - Country:US
Practice Address - Phone:845-856-5298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10 306374164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse