Active NPI
Mary Elizabeth Kroetsch, RPH
- Geriatric Pharmacist
- Grand Island, NY
National Provider Identifier
1356468706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Pharmacist
- License
- 031947-1
- Practice address
- 310 Baseline Rd
Grand Island, NY 14072-3050 - Phone
- (716) 773-4332
- NPI assigned
- Mar 23, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 031947-1 | NY | Primary |
Addresses
Primary practice location
310 Baseline Rd
Grand Island, NY 14072-3050
Mailing address
310 Baseline Rd
Grand Island, NY 14072-3050
Phone (716) 773-4332
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 |
|---|---|---|---|
| 031947-1 | NY | MD | Geriatric Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356468706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "310 BASELINE RD",
"city": "GRAND ISLAND",
"state": "NY",
"postal_code": "140723050",
"telephone_number": "716-773-4332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 BASELINE RD",
"city": "GRAND ISLAND",
"state": "NY",
"postal_code": "140723050",
"telephone_number": "716-773-4332"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KROETSCH",
"first_name": "MARY",
"middle_name": "ELIZABETH",
"name_prefix": "Mrs.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1835G0303X",
"taxonomy_group": "",
"desc": "Pharmacist, Geriatric",
"state": "NY",
"license": "031947-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.