Healthcare Provider Details

I. General information

NPI: 1306005962
Provider Name (Legal Business Name): NATAN KROHN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2008
Last Update Date: 08/09/2023
Certification Date: 08/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 CLIFTON AVE
CLIFTON NJ
07013-3518
US

IV. Provider business mailing address

1130 MCBRIDE AVE FL 3
WOODLAND PARK NJ
07424-3806
US

V. Phone/Fax

Practice location:
  • Phone: 973-471-8200
  • Fax: 973-471-3032
Mailing address:
  • Phone: 973-812-1400
  • Fax: 973-812-1404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number25MA09497200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: