Provider Demographics
NPI:1316026735
Name:KRECKO, ANDREJS (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREJS
Middle Name:
Last Name:KRECKO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 LEFFERTS RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-1734
Mailing Address - Country:US
Mailing Address - Phone:516-747-7262
Mailing Address - Fax:
Practice Address - Street 1:131 LEFFERTS RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-1734
Practice Address - Country:US
Practice Address - Phone:516-747-7262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-05
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0352101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice