Provider Demographics
NPI:1689645293
Name:KRIM, EILEEN (MD)
Entity Type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:
Last Name:KRIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:488 GREAT NECK RD STE 201
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-4315
Mailing Address - Country:US
Mailing Address - Phone:516-482-6747
Mailing Address - Fax:
Practice Address - Street 1:488 GREAT NECK RD STE 201
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-4315
Practice Address - Country:US
Practice Address - Phone:516-482-6747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY128018207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY13A041Medicare ID - Type Unspecified
NYB02457Medicare UPIN