Provider Demographics
NPI:1730402918
Name:KRAVAT, MONTE (RPH)
Entity type:Individual
Prefix:MR
First Name:MONTE
Middle Name:
Last Name:KRAVAT
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 1:3134 PERRY AVE
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-4217
Mailing Address - Country:US
Mailing Address - Phone:516-242-5349
Mailing Address - Fax:516-764-0141
Practice Address - Street 1:749 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-2515
Practice Address - Country:US
Practice Address - Phone:516-354-3545
Practice Address - Fax:516-358-7096
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034794183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist