Provider Demographics
NPI:1356524821
Name:KRAZINSKI, WILLIAM V (RPH)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:V
Last Name:KRAZINSKI
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 1:128 BROWN RD
Mailing Address - Street 2:
Mailing Address - City:HORSEHEADS
Mailing Address - State:NY
Mailing Address - Zip Code:14845-7969
Mailing Address - Country:US
Mailing Address - Phone:607-426-8109
Mailing Address - Fax:315-789-2268
Practice Address - Street 1:3217 SILVERBACK LN
Practice Address - Street 2:
Practice Address - City:PAINTED POST
Practice Address - State:NY
Practice Address - Zip Code:14870-8911
Practice Address - Country:US
Practice Address - Phone:607-937-9627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-07
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036931183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00446768Medicaid