Healthcare Provider Details

I. General information

NPI: 1902770027
Provider Name (Legal Business Name): DAVID A KRULEE MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2025
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 BRACKETT RD
EASTHAM MA
02642-2703
US

IV. Provider business mailing address

180 BRACKETT RD
EASTHAM MA
02642-2703
US

V. Phone/Fax

Practice location:
  • Phone: 860-207-9449
  • Fax: 959-206-0723
Mailing address:
  • Phone: 860-207-9449
  • Fax: 959-206-0723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DAVID A KRULEE
Title or Position: OWNER
Credential: MD
Phone: 860-573-3833