MEDICARE: DR. AARON JUSTIN KRILL 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	208800000X	Urology Physician	MD037609	DC
2	2088P0231X	Pediatric Urology Physician	259568	NY

General Provider Information

NPI Number	:	1427294099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AARON JUSTIN KRILL MD

Provider Business Mailing Address
First Line	:	1999 MARCUS AVE STE M18
Second Line	:	DEPARTMENT OF PEDIATRIC UROLOGY
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11042-1023
Country	:	US
Telephone Number	:	516-466-6953
Fax Number	:	516-466-5608

Provider Business Practice Location Address
First Line	:	1999 MARCUS AVE STE M18
Second Line	:	DEPARTMENT OF PEDIATRIC UROLOGY
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11042-1023
Country	:	US
Telephone Number	:	516-466-6953
Fax Number	:	516-466-5608

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

Provider Enumeration Date	:	01/01/2009
Last Update Date	:	05/19/2011

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