Provider Demographics
NPI:1407831324
Name:KREUTZER, ERIC R (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:R
Last Name:KREUTZER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:532 BROADHOLLOW RD
Mailing Address - Street 2:SUITE 142
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-3672
Mailing Address - Country:US
Mailing Address - Phone:516-931-0041
Mailing Address - Fax:
Practice Address - Street 1:1695 EASTCHESTER RD
Practice Address - Street 2:SUITE 501
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2374
Practice Address - Country:US
Practice Address - Phone:718-904-1130
Practice Address - Fax:718-904-1950
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-13
Last Update Date:2014-11-24
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Provider Licenses
StateLicense IDTaxonomies
NY161204208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE94687Medicare UPIN