1003390444 NPI number — TATYANA KRYACHKOV CRNP

Table of content: TATYANA KRYACHKOV CRNP (NPI 1003390444)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003390444 NPI number — TATYANA KRYACHKOV CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KRYACHKOV
Provider First Name:
TATYANA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003390444
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/27/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
429 4TH AVE FL 7
Provider Second Line Business Mailing Address:
4000 S. FABER PLACE DRIVE, SUITE 300, NORTH CHARLESTON
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15219-1500
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-731-8994
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
429 4TH AVE FL 7
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15219-1500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-731-8994
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/21/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  SP019246 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LP2300X , with the licence number: SP019246 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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