Provider Demographics
NPI:1689952269
Name:KRYSTAL, JULIE IRENE (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:IRENE
Last Name:KRYSTAL
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Gender:F
Credentials:MD
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Mailing Address - Street 1:269-01 76TH AVE
Mailing Address - Street 2:SUITE 255
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1402
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:269-01 76TH AVE
Practice Address - Street 2:SUITE 255
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1402
Practice Address - Country:US
Practice Address - Phone:718-470-3460
Practice Address - Fax:718-343-4642
Is Sole Proprietor?:No
Enumeration Date:2011-07-29
Last Update Date:2012-08-28
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Provider Licenses
StateLicense IDTaxonomies
NY2635642080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology