Provider Demographics
NPI:1093993511
Name:CHRISTOPHER J. KRUGER, M.D.
Entity Type:Organization
Organization Name:CHRISTOPHER J. KRUGER, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMIN., OFC MGR.
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:J
Authorized Official - Last Name:WYLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-471-8410
Mailing Address - Street 1:7 FOX ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-4716
Mailing Address - Country:US
Mailing Address - Phone:845-471-8410
Mailing Address - Fax:845-471-8459
Practice Address - Street 1:7 FOX ST
Practice Address - Street 2:SUITE 101
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-4716
Practice Address - Country:US
Practice Address - Phone:845-471-8410
Practice Address - Fax:845-471-8459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171627207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01341928Medicaid
NY3C1697OtherPHS HEALTHNET
NY46Z011OtherEMPIRE BLUE CROSS
NY9668573OtherCIGNA
NY10050175 GROUP 8588OtherC. D. P. H. P
NY177128OtherM. V. P.
NYDUS057OtherOXFORD
NY2336172OtherAETNA
NY46Z011OtherEMPIRE BLUE CROSS
NYDUS057OtherOXFORD