Provider Demographics
NPI:1437157401
Name:KRUGER, BERNARD MAURICE (MD)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:MAURICE
Last Name:KRUGER
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 1:170 E 78TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-0497
Mailing Address - Country:US
Mailing Address - Phone:212-772-9222
Mailing Address - Fax:212-879-7235
Practice Address - Street 1:170 E 78TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-0497
Practice Address - Country:US
Practice Address - Phone:212-772-9222
Practice Address - Fax:212-879-7235
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY125489207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB13075Medicare UPIN