Provider Demographics
NPI:1568760171
Name:KRAFT, ROBERT LEE (DO, RPH)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LEE
Last Name:KRAFT
Suffix:
Gender:M
Credentials:DO, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 OWASCO ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-4059
Mailing Address - Country:US
Mailing Address - Phone:315-252-9204
Mailing Address - Fax:
Practice Address - Street 1:62 OWASCO ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-4059
Practice Address - Country:US
Practice Address - Phone:315-252-9204
Practice Address - Fax:315-568-1611
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-06
Last Update Date:2024-09-27
Deactivation Date:2020-08-13
Deactivation Code:
Reactivation Date:2020-08-26
Provider Licenses
StateLicense IDTaxonomies
NC13235183500000X
NY043074183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist