Provider Demographics
NPI:1245554963
Name:KRANJAC, JOHN (RPH)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:KRANJAC
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 1:6352 WOODHAVEN BLVD
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-2856
Mailing Address - Country:US
Mailing Address - Phone:718-651-1000
Mailing Address - Fax:718-476-3776
Practice Address - Street 1:6352 WOODHAVEN BLVD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374
Practice Address - Country:US
Practice Address - Phone:718-651-1000
Practice Address - Fax:718-476-3776
Is Sole Proprietor?:No
Enumeration Date:2010-03-24
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038094183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist