Individual
MRS. THERESA MARIE KRAWCHUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSED
Contact information
Practice address
7 SUSAN CT, HOLTSVILLE, NY 11742-1665
(631) 654-4779
Mailing address
7 SUSAN CT, HOLTSVILLE, NY 11742-1665
(631) 654-4779
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
550216041
NY
Other
Enumeration date
06/13/2012
Last updated
06/13/2012
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