Individual
DR. IRVIN KRUKENKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
206593
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01744389
—
NY
01
—
5450494
AETNA
NY
01
—
92F641
EMPIRE BC.BS
NY
Enumeration date
07/24/2006
Last updated
07/08/2007
Update your record
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