Individual
MS. LAURA GRACE KRUKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
100 PORT WASHINGTON BLVD, ROSLYN, NY 11576
(516) 562-6000
Mailing address
80 NORTH MAPLE STREET, MASSAPEQUA, NY 11758
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
024746
NY
Other
Enumeration date
02/26/2020
Last updated
02/26/2020
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