Individual
ANDREW J KREBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
STONY BROOK UNIVERSITY/PSYCHIATRY DEPARTMENT, 101 NICHOLS ROAD HSC LEVEL 10 ROOM 020, STONY BROOK, NY 11794-8101
(631) 555-5555
Mailing address
STONY BROOK UNIVERSITY/PSYCHIATRY DEPARTMENT, 101 NICHOLS ROAD HSC LEVEL 10 ROOM 020, STONY BROOK, NY 11794-8101
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
315558
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2018
Last updated
07/13/2022
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