Provider Demographics
NPI:1497739874
Name:KRUH, IVAN PETER (PHD)
Entity Type:Individual
Prefix:DR
First Name:IVAN
Middle Name:PETER
Last Name:KRUH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1754
Mailing Address - Street 2:
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562-0075
Mailing Address - Country:US
Mailing Address - Phone:914-949-7699
Mailing Address - Fax:914-949-3224
Practice Address - Street 1:141 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-1912
Practice Address - Country:US
Practice Address - Phone:914-949-7699
Practice Address - Fax:914-949-3224
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015396103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist