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Individual

DR. TRACY LYNN KRUZICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
80 ERDMAN WAY STE 315, LEOMINSTER, MA 01453-1840
(978) 537-4805
Mailing address
PO BOX 1000 DEPT 453, MEMPHIS, TN 38148-0001
(828) 575-2625
(828) 350-2174

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
238418
MA
207K00000X
Allergy & Immunology Physician
DR.0046645
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
029563
KAISER COMMERCIAL NUMBER
CO
05
9000200004
CO
01
FK0056728
DEA
CO
Enumeration date
12/18/2006
Last updated
05/10/2024
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