Healthcare Provider Details

I. General information

NPI: 1841226008
Provider Name (Legal Business Name): FELIX GEORGE KRAVETS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 02/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 STOCKTON DR
TOMS RIVER NJ
08755-6433
US

IV. Provider business mailing address

21 STOCKTON DR
TOMS RIVER NJ
08755-6433
US

V. Phone/Fax

Practice location:
  • Phone: 732-286-6333
  • Fax: 732-505-0325
Mailing address:
  • Phone: 732-286-6333
  • Fax: 732-505-0325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number25MA080941000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: