Provider Demographics
NPI:1528347283
Name:KROLEWSKI, BROOKE TAYLOR (PHARMD)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:TAYLOR
Last Name:KROLEWSKI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4505 PINTA LN
Mailing Address - Street 2:APT # 202
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-6776
Mailing Address - Country:US
Mailing Address - Phone:570-239-6787
Mailing Address - Fax:
Practice Address - Street 1:5313 HENNEMAN DRIVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23513
Practice Address - Country:US
Practice Address - Phone:757-852-5137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-12
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202210851183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist