Provider Demographics
NPI:1861671265
Name:ANNA N KROL PHYSICIAN PC
Entity Type:Organization
Organization Name:ANNA N KROL PHYSICIAN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:N
Authorized Official - Last Name:KROL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-285-9260
Mailing Address - Street 1:2000 KINGS HWY
Mailing Address - Street 2:STE 1E
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1445
Mailing Address - Country:US
Mailing Address - Phone:718-285-9260
Mailing Address - Fax:718-285-9266
Practice Address - Street 1:2000 KINGS HWY
Practice Address - Street 2:STE 1E
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1445
Practice Address - Country:US
Practice Address - Phone:718-285-9260
Practice Address - Fax:718-285-9266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-01
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY209914208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01878266Medicaid
NY01878266Medicaid