Provider Demographics
NPI:1932482817
Name:KRYZANEKAS, ELAINE PATRICIA (RPH, PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:PATRICIA
Last Name:KRYZANEKAS
Suffix:
Gender:F
Credentials:RPH, PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 ROUTE 37 W
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-5049
Mailing Address - Country:US
Mailing Address - Phone:732-349-0517
Mailing Address - Fax:732-281-3528
Practice Address - Street 1:1311 ROUTE 37 W
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-5049
Practice Address - Country:US
Practice Address - Phone:732-349-0517
Practice Address - Fax:732-281-3528
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02531500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RI02531500OtherPHARMACIST LICENSE #