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General NPI Number Information
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NPI Number | 1215936604
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Entity Type | Individual
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Provider Name | GEDDY JAY KRUL MD
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Gender | Male
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Dates
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Enumeration Date | 07/18/2005
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 10301 HAGEN RANCH RD STE 760
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City | BOYNTON BEACH
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State | FL
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Zip | 33437-3777
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Country | US
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Telephone | 561-733-4400
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Fax | 561-733-5004
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Provider Business Mailing Address
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Address Line | 381 CHESTNUT ST
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City | UNION
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State | NJ
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Zip | 07083-9430
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Country | US
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Telephone | 908-688-8007
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Fax | 908-688-3884
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME174747
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 25MA05108200
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License Number State | NJ
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