Provider Demographics
NPI:1629149497
Name:KRISTINE KROL MD PA
Entity Type:Organization
Organization Name:KRISTINE KROL MD PA
Other - Org Name:ALLERCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KROL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-725-8666
Mailing Address - Street 1:177 W HIGH ST
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-1817
Mailing Address - Country:US
Mailing Address - Phone:908-725-8666
Mailing Address - Fax:908-725-2223
Practice Address - Street 1:177 W HIGH ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-1817
Practice Address - Country:US
Practice Address - Phone:908-725-8666
Practice Address - Fax:908-725-2223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05347300207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJB19858Medicare UPIN
NJ190581Medicare ID - Type Unspecified