Provider Demographics
NPI:1548789662
Name:KRAVCHICK, SERGEY (MD)
Entity Type:Individual
Prefix:MR
First Name:SERGEY
Middle Name:
Last Name:KRAVCHICK
Suffix:
Gender:M
Credentials:MD
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Other - Suffix:
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Mailing Address - Street 1:750 EAST ADAMS STREET
Mailing Address - Street 2:DEPARTMENT OF UROLOGY SUNY UPSTATE MEDICAL UNIVERSITY
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210
Mailing Address - Country:US
Mailing Address - Phone:315-464-4473
Mailing Address - Fax:315-464-6112
Practice Address - Street 1:750 EAST ADAMS STREET
Practice Address - Street 2:DEPARTMENT OF UROLOGY SUNY UPSTATE MEDICAL UNIVERSITY
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210
Practice Address - Country:US
Practice Address - Phone:315-464-4473
Practice Address - Fax:315-464-6112
Is Sole Proprietor?:No
Enumeration Date:2017-09-11
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY290590208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology