Provider Demographics
NPI:1811480932
Name:SKRZYPCZYK, JOLANTA (RPH)
Entity type:Individual
Prefix:
First Name:JOLANTA
Middle Name:
Last Name:SKRZYPCZYK
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 1:1511 ROUTE 22
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-4020
Mailing Address - Country:US
Mailing Address - Phone:845-940-0565
Mailing Address - Fax:
Practice Address - Street 1:1511 ROUTE 22
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-4020
Practice Address - Country:US
Practice Address - Phone:845-940-0565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-13
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0010215183500000X
NY046205183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist