Provider Demographics
NPI:1184804395
Name:DREXLER, KENNETH LAURENCE (RPH)
Entity type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:LAURENCE
Last Name:DREXLER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:939 HEWLETT DR
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-2728
Mailing Address - Country:US
Mailing Address - Phone:516-791-1686
Mailing Address - Fax:
Practice Address - Street 1:152 MIDDLE NECK RD
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-1246
Practice Address - Country:US
Practice Address - Phone:516-482-5098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029474183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist