Individual
DR. GREGORY P CRUCIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
650 HUEBNER RD, FORT RILEY, FORT RILEY, KS 66442
(850) 883-8150
Mailing address
5313 STONE CREST DR, MANHATTAN, KS 66503-8757
(915) 255-9869
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY5730
FL
103T00000X
Psychologist
PY5730
FL
103TC0700X
Clinical Psychologist
PY5730
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
371230300
—
FL
Enumeration date
06/17/2006
Last updated
10/27/2023
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