Provider Demographics
NPI:1366606378
Name:KRAFT, DAVID RICHARD (MS, RN, NP-C)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:RICHARD
Last Name:KRAFT
Suffix:
Gender:M
Credentials:MS, RN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:122 SYCAMORE DR
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2427
Mailing Address - Country:US
Mailing Address - Phone:516-747-0991
Mailing Address - Fax:516-739-1405
Practice Address - Street 1:122 SYCAMORE DR
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-2427
Practice Address - Country:US
Practice Address - Phone:516-747-0991
Practice Address - Fax:516-739-1405
Is Sole Proprietor?:No
Enumeration Date:2008-07-18
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY541291163W00000X
NY304806363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse