Individual
MRS. STEPHANIE J KRUSZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
750 RESERVOIR AVE, CRANSTON, RI 02910
(401) 464-6617
(401) 464-6673
Mailing address
905 PONTIAC AVE, CRANSTON, RI 02920-7903
(401) 464-6617
(401) 464-6673
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9044
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04066U2
UNITED
—
01
—
0757040
CIGNA
—
01
—
2590935
AETNA
—
01
—
291657
BLUE CROSS
RI
01
—
404753
TUFTS
—
01
—
408319
B CHIP
RI
01
—
4213
NHOOD
—
05
—
9023286
—
RI
Enumeration date
09/26/2006
Last updated
08/01/2019
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