Provider Demographics
NPI:1740319870
Name:KRENITSKY, GABRIEL (MD)
Entity type:Individual
Prefix:
First Name:GABRIEL
Middle Name:
Last Name:KRENITSKY
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 1:425 METRO PL N
Mailing Address - Street 2:SUITE 175
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-5325
Mailing Address - Country:US
Mailing Address - Phone:614-937-4883
Mailing Address - Fax:
Practice Address - Street 1:425 METRO PL N
Practice Address - Street 2:SUITE 175
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-5325
Practice Address - Country:US
Practice Address - Phone:614-937-4883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH77159208600000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2230384Medicare ID - Type Unspecified
OHH31650Medicare UPIN