Provider Demographics
NPI:1083689418
Name:KRABILL, KEITH (MD)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:
Last Name:KRABILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 FLINT RD
Mailing Address - Street 2:CENTER FOR LABORATORY MEDICINE
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-3058
Mailing Address - Country:US
Mailing Address - Phone:716-626-7200
Mailing Address - Fax:
Practice Address - Street 1:115 FLINT RD
Practice Address - Street 2:CENTER FOR LABORATORY MEDICINE
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-3058
Practice Address - Country:US
Practice Address - Phone:716-626-7200
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY191464207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCC6492Medicare ID - Type Unspecified
NYG38035Medicare UPIN