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General NPI Number Information
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NPI Number | 1245602143
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Entity Type | Organization
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Legal Business Name | VISION NYC JONATHAN KRUH MD PLLC
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Dates
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Enumeration Date | 10/30/2015
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Last Update Date | 10/30/2015
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Provider Practice Location Address
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Address Line | 25 5TH AVE SUITE 1B
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City | NEW YORK
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State | NY
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Zip | 10003-4307
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Country | US
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Telephone | 646-799-3648
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Fax | 212-225-8416
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Provider Business Mailing Address
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Address Line | 24039 66TH AVE
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City | DOUGLASTON
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State | NY
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Zip | 11362-1924
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Country | US
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Telephone | 646-799-3648
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Fax | 212-225-8416
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. ROSEMARY KRUH
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Credential |
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Telephone | 646-799-3648
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 260221
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License Number State | NY
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