Provider Demographics
NPI:1386768893
Name:SKRYPEK, RICHARD ANDREW
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:ANDREW
Last Name:SKRYPEK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14469-9337
Mailing Address - Country:US
Mailing Address - Phone:585-657-5321
Mailing Address - Fax:
Practice Address - Street 1:4238 RECREATION DR
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424
Practice Address - Country:US
Practice Address - Phone:585-394-5350
Practice Address - Fax:585-394-6997
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040732183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist