Individual
JOHN PAUL KRETKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1444 5TH AVE, BAY SHORE, NY 11706-4147
(631) 650-0115
Mailing address
1444 5TH AVE, BAY SHORE, NY 11706-4147
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/18/2019
Last updated
12/18/2019
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