Provider Demographics
NPI:1861480170
Name:KRULEWSKI, THOMAS FRANK (MD PHD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:FRANK
Last Name:KRULEWSKI
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 PLAZA BLVD
Mailing Address - Street 2:STE 103
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2738
Mailing Address - Country:US
Mailing Address - Phone:717-735-6700
Mailing Address - Fax:717-735-8113
Practice Address - Street 1:810 PLAZA BLVD
Practice Address - Street 2:STE 103
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2738
Practice Address - Country:US
Practice Address - Phone:717-735-6700
Practice Address - Fax:717-735-8113
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD052784L207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01469459Medicaid
KR769921FWFMedicare ID - Type Unspecified
F80567Medicare UPIN