Provider Demographics
NPI:1710101696
Name:KRAJEWSKI, KRISTIN CAROLINE (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:CAROLINE
Last Name:KRAJEWSKI
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:CAROLINE
Other - Last Name:MIKOLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:90 PEARCE DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-4932
Mailing Address - Country:US
Mailing Address - Phone:716-400-8768
Mailing Address - Fax:
Practice Address - Street 1:3495 BAILEY AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-1129
Practice Address - Country:US
Practice Address - Phone:716-834-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050443183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist