Provider Demographics
NPI:1275528465
Name:KROL, KRISTINE (MD)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:
Last Name:KROL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 W HIGH ST
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-1817
Mailing Address - Country:US
Mailing Address - Phone:908-725-8666
Mailing Address - Fax:908-725-2223
Practice Address - Street 1:177 W HIGH ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-1817
Practice Address - Country:US
Practice Address - Phone:908-725-8666
Practice Address - Fax:908-725-2223
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY151152207K00000X
NJMA053473207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ190581Medicare ID - Type Unspecified
NYB19858Medicare UPIN
NJB19858Medicare UPIN
NY90A331Medicare ID - Type Unspecified