Provider Demographics
NPI:1184946469
Name:KRAVETS, ANNA (RPH)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:KRAVETS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 BRANDYWINE DR
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-9685
Mailing Address - Country:US
Mailing Address - Phone:800-444-5100
Mailing Address - Fax:800-838-4918
Practice Address - Street 1:120 FIELDCREST AVE
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-3656
Practice Address - Country:US
Practice Address - Phone:800-444-5100
Practice Address - Fax:800-838-4918
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-27
Last Update Date:2010-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02522900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist