MEDICARE: RUVIM KRUPKIN 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	207RH0003X	Hematology & Oncology Physician	208194	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	:	1942205042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUVIM KRUPKIN M.D.

Provider Business Mailing Address
First Line	:	2844 OCEAN PARKWAY SUITE #5
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-7904
Country	:	US
Telephone Number	:	718-266-1500
Fax Number	:	718-266-1583

Provider Business Practice Location Address
First Line	:	2844 OCEAN PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-7900
Country	:	US
Telephone Number	:	718-266-1500
Fax Number	:	718-266-1500

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

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	10/01/2016

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