Individual
ANNA KRYUCHKOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2223 CLOVE RD, STATEN ISLAND, NY 10305-1523
(917) 449-5986
(718) 849-6523
Mailing address
2223 CLOVE RD, STATEN ISLAND, NY 10305-1523
(917) 449-5986
(718) 849-6523
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
00219931
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02253703
—
NY
01
—
5303487
GHI
NY
01
—
8L0251
BLUE SHIELD
NY
Enumeration date
09/20/2006
Last updated
03/09/2017
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