Provider Demographics
NPI:1285958785
Name:KREYCHMAN, IRINA (RPH)
Entity type:Individual
Prefix:MRS
First Name:IRINA
Middle Name:
Last Name:KREYCHMAN
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 1:310 GLEN COVE RD
Mailing Address - Street 2:HARBOR HILL PHARMACY
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-1846
Mailing Address - Country:US
Mailing Address - Phone:516-621-1185
Mailing Address - Fax:
Practice Address - Street 1:310 GLEN COVE RD
Practice Address - Street 2:HARBOR HILL PHARMACY
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11576-1846
Practice Address - Country:US
Practice Address - Phone:516-621-1185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-26
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046636183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist