Active NPI
Jeffrey Michael Kruk, R.PH.
- Geriatric Pharmacist
- Newport, PA
National Provider Identifier
1205019692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Pharmacist
- License
- 1835G0303X
- Practice address
- 28 S 2ND St
Newport, PA 17074-1401 - Phone
- (717) 567-2147
- NPI assigned
- Dec 10, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Pharmacist | 1835G0303X | 1835G0303X | PA | Primary |
Addresses
Primary practice location
28 S 2ND St
Newport, PA 17074-1401
Mailing address
951 Cressman Rd
Schwenksville, PA 19473-2115
Phone (610) 584-4459
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1835G0303X | PA | MD | Geriatric Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197244800000",
"number": "1205019692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "951 CRESSMAN RD",
"city": "SCHWENKSVILLE",
"state": "PA",
"postal_code": "194732115",
"telephone_number": "610-584-4459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28 S 2ND ST",
"city": "NEWPORT",
"state": "PA",
"postal_code": "170741401",
"telephone_number": "717-567-2147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUK",
"first_name": "JEFFREY",
"middle_name": "MICHAEL",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-10",
"last_updated": "2007-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "1835G0303X",
"taxonomy_group": "",
"desc": "Pharmacist, Geriatric",
"state": "PA",
"license": "1835G0303X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.