Provider Demographics
NPI:1932703113
Name:KRZYZEWSKI, PETER ROY (PHARMD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:ROY
Last Name:KRZYZEWSKI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 PLYMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:HALIFAX
Mailing Address - State:MA
Mailing Address - Zip Code:02338-1340
Mailing Address - Country:US
Mailing Address - Phone:781-293-5786
Mailing Address - Fax:844-411-6221
Practice Address - Street 1:341 PLYMOUTH ST
Practice Address - Street 2:
Practice Address - City:HALIFAX
Practice Address - State:MA
Practice Address - Zip Code:02338-1340
Practice Address - Country:US
Practice Address - Phone:781-293-5786
Practice Address - Fax:844-411-6221
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-28
Last Update Date:2020-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH27579183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist