Provider Demographics
NPI:1710956925
Name:KRASINSKY, WALTER GREGORY (MD)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:GREGORY
Last Name:KRASINSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 HIGHLANDS MALL
Mailing Address - Street 2:
Mailing Address - City:NATRONA HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:15065-1972
Mailing Address - Country:US
Mailing Address - Phone:724-226-3333
Mailing Address - Fax:724-224-2121
Practice Address - Street 1:52 HIGHLANDS MALL
Practice Address - Street 2:
Practice Address - City:NATRONA HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:15065-1972
Practice Address - Country:US
Practice Address - Phone:724-226-3333
Practice Address - Fax:724-224-2121
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD420357174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1013901640001Medicaid
PAI07433Medicare UPIN
PA091560Medicare ID - Type Unspecified