MEDICARE: RICHARD KRUGLEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0805X	Geriatric Psychiatry Physician	132755-1	NY
2	2084P0800X	Psychiatry Physician	132755-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366430217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD KRUGLEY MD

Provider Business Mailing Address
First Line	:	165 LEFFERTS RD
Second Line	:
City	:	WOODMERE
State	:	NY
Zip	:	11598-1347
Country	:	US
Telephone Number	:	914-949-1199
Fax Number	:	914-949-1245

Provider Business Practice Location Address
First Line	:	755 HEMPSTEAD TPKE
Second Line	:
City	:	UNIONDALE
State	:	NY
Zip	:	11553-1111
Country	:	US
Telephone Number	:	631-608-5620
Fax Number	:	631-396-0382

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2005
Last Update Date	:	04/24/2025

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Directions to “ RICHARD KRUGLEY MD” Practice Location

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