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Individual

DR. STACEY JILL KRUGER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
600 NORTH BOULEVARD, SUITE 220, GREAT NECK, NY 11021
(516) 470-2020
(516) 470-2000
Mailing address
600 NORTH BOULEVARD, SUITE 220, GREAT NECK, NY 11021
(516) 470-2020
(516) 470-2000

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
211514
NY
207W00000X
Ophthalmology Physician
ME85180
FL
207WX0110X
Pediatric Ophthalmology and Strabismus Specialist Physician
211514
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
042834
NEIGHBORHOOD HEALTH
FL
01
043826038
HUMANA
FL
01
11135
DIMENSION HEALTH PLAN
FL
01
2003619
CIGNA
FL
01
2108536
FIRST HEALTH
FL
01
2352758
UNITED HEALTHCARE
FL
05
265186600
FL
01
2891680
AETNA HMO
FL
01
29061
BCBS
FL
01
7467368
AETNA
FL
Enumeration date
12/11/2006
Last updated
08/29/2024
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