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General NPI Number Information
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NPI Number | 1225214968
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Entity Type | Organization
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Legal Business Name | STEPHEN J KRULJAC, D.P.M., P.C.
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Dates
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Enumeration Date | 01/11/2008
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Last Update Date | 01/08/2014
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Provider Practice Location Address
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Address Line | 495 EAST WATERFRONT DRIVE SUITE 230
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City | HOMESTEAD
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State | PA
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Zip | 15120-1151
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Country | US
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Telephone | 412-461-1108
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Fax | 412-461-5490
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Provider Business Mailing Address
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Address Line | 495 EAST WATERFRONT DRIVE SUITE 230
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City | HOMESTEAD
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State | PA
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Zip | 15120-1151
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Country | US
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Telephone | 412-461-1108
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Fax | 412-461-5490
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Authorized Official
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Title or Position | OWNER
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Name | STEPHEN J KRULJAC
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Credential | D.P.M.
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Telephone | 412-461-1108
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | SC002458L
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License Number State | PA
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