Individual
DR. JEFFREY DAVID KRUKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
5800 N BAYSHORE DRIVE, SUITE A250 NORTH SHORE PSYCHOTHERAPY ASSOCIATES, GLENDALE, WI 53217
(414) 962-6764
(414) 962-6765
Mailing address
5800 N BAYSHORE DRIVE, SUITE A250 NORTH SHORE PSYCHOTHERAPY ASSOCIATES, GLENDALE, WI 53217
(414) 962-6764
(414) 962-6765
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2489057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39144400
—
WI
Enumeration date
11/30/2006
Last updated
07/08/2007
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