Provider Demographics
NPI:1568532489
Name:KRAFT, JOHN H (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:H
Last Name:KRAFT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CREST RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BAY
Mailing Address - State:NY
Mailing Address - Zip Code:11743-1508
Mailing Address - Country:US
Mailing Address - Phone:516-458-7141
Mailing Address - Fax:631-665-3416
Practice Address - Street 1:75 5TH AVE
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-7306
Practice Address - Country:US
Practice Address - Phone:631-256-9961
Practice Address - Fax:631-256-9961
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYXO10614111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor