MEDICARE: KAREN KRUTCHICK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	276399	NY

General Provider Information

NPI Number	:	1457795452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN KRUTCHICK M.D.

Provider Business Mailing Address
First Line	:	5344 SACANDAGA RD
Second Line	:
City	:	GALWAY
State	:	NY
Zip	:	12074-2422
Country	:	US
Telephone Number	:	518-882-6955
Fax Number	:	518-882-9051

Provider Business Practice Location Address
First Line	:	48 ERIE BLVD
Second Line	:
City	:	CANAJOHARIE
State	:	NY
Zip	:	13317-1133
Country	:	US
Telephone Number	:	518-673-2573
Fax Number	:	518-673-2781

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2013
Last Update Date	:	12/06/2024

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