MEDICARE: NADEZHDA KREBS M.D.

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	207L00000X	Anesthesiology Physician	251147	NY

General Provider Information

NPI Number	:	1649463530
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NADEZHDA KREBS M.D.

Provider Business Mailing Address
First Line	:	PO BOX 12023
Second Line	:
City	:	NEWARK
State	:	NJ
Zip	:	07101-5023
Country	:	US
Telephone Number	:	800-627-4470
Fax Number	:	412-937-5710

Provider Business Practice Location Address
First Line	:	2010 30TH AVENUE
Second Line	:	MOUNT SINAI HOSPITAL OF QUEENS
City	:	ASTORIA
State	:	NY
Zip	:	11102
Country	:	US
Telephone Number	:	212-427-2666
Fax Number	:	212-289-6929

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

Provider Enumeration Date	:	08/23/2007
Last Update Date	:	05/14/2013

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