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General NPI Number Information
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NPI Number | 1376163519
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Entity Type | Individual
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Provider Name | TZVI MENACHEM KRUPKA DDS
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Gender | Male
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Dates
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Enumeration Date | 04/17/2020
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Last Update Date | 08/29/2024
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Provider Practice Location Address
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Address Line | 100 WOODS RD
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City | VALHALLA
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State | NY
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Zip | 10595-1530
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Country | US
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Telephone | 914-493-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 5 ANNABELLE AVE
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City | CLIFTON
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State | NJ
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Zip | 07012-1805
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Country | US
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Telephone | 973-934-3657
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Fax |
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 22DI02892000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 064215
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License Number State | NY
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