Provider Demographics
NPI:1558528984
Name:ROBERT F. KRALL
Entity Type:Organization
Organization Name:ROBERT F. KRALL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-677-5012
Mailing Address - Street 1:61 FRONT ST
Mailing Address - Street 2:BOX 570
Mailing Address - City:MILLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:12545-5961
Mailing Address - Country:US
Mailing Address - Phone:845-677-5012
Mailing Address - Fax:845-677-5024
Practice Address - Street 1:61 FRONT ST
Practice Address - Street 2:BOX 570
Practice Address - City:MILLBROOK
Practice Address - State:NY
Practice Address - Zip Code:12545-5961
Practice Address - Country:US
Practice Address - Phone:845-677-5012
Practice Address - Fax:845-677-5024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT81416Medicare UPIN
NYC18791Medicare PIN