Brian Krupper
Individual provider Active NPI Pharmacist · Marcy, NY
NPI 1629206396 · NPPES record last updated Jul 1, 2009
Key facts
- NPI
- 1629206396
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 33391 (NY)
- Practice address
- 9005 Old River Rd
Marcy, NY 13403-3000 - Phone
- (315) 765-3783
- Fax
- (315) 765-3789
- NPI assigned
- Jul 1, 2009
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33391 | NY | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 33391 | NY | Yes |
Addresses
Primary practice location
9005 Old River Rd
Marcy, NY 13403-3000
Mailing address
PO Box 300
Marcy, NY 13403-0300
Phone (315) 765-3783
Other providers in Marcy, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.