Individual
KEVIN J. KRUCKENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
80 SEYMOUR ST, HARTFORD, CT 06102-8000
(860) 716-5348
Mailing address
80 SEYMOUR ST, HARTFORD, CT 06102-8000
(860) 716-5348
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
007007
CT
363A00000X
Physician Assistant
PA8259
MA
Other
Enumeration date
08/02/2021
Last updated
05/27/2025
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