Healthcare Provider Details

I. General information

NPI: 1609896273
Provider Name (Legal Business Name): GERARD KRUGER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 W MAIN ST
SHARON CT
06069-2012
US

IV. Provider business mailing address

200 KENNEDY DR
TORRINGTON CT
06790-3096
US

V. Phone/Fax

Practice location:
  • Phone: 860-364-0531
  • Fax: 860-496-4951
Mailing address:
  • Phone: 860-482-5384
  • Fax: 860-489-1799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number24325
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number024325
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: