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Contact Information

IRVIN KRUKENKAMP, MD
UNIVERSITY HOSPITAL, L5
STONY BROOK, NY11794
 Phone: 631-444-2565
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for IRVIN KRUKENKAMP · (Male)

NPI Number 1457373292
Status Active
Credentials MD
Entity Individual
Enumeration date 07/24/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 206593
  • NY Medicaid 01744389
  • NY Other 5450494 AETNA
  • NY Other 92F641 EMPIRE BC.BS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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