MEDICARE: DR. GREGORY PAUL KRUMHOLZ D.C.

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	111N00000X	Chiropractor	X008489-1	NY

General Provider Information

NPI Number	:	1912072034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY PAUL KRUMHOLZ D.C.

Provider Business Mailing Address
First Line	:	258 E SUFFOLK AVE
Second Line	:
City	:	CENTRAL ISLIP
State	:	NY
Zip	:	11722-2634
Country	:	US
Telephone Number	:	631-348-6780
Fax Number	:	631-348-6780

Provider Business Practice Location Address
First Line	:	258 E SUFFOLK AVE
Second Line	:
City	:	CENTRAL ISLIP
State	:	NY
Zip	:	11722-2634
Country	:	US
Telephone Number	:	631-348-6780
Fax Number	:	631-348-6780

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

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	07/08/2007

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