Provider Demographics
NPI:1750617643
Name:KRUPA, HALINA (DC)
Entity type:Individual
Prefix:
First Name:HALINA
Middle Name:
Last Name:KRUPA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:NJ
Mailing Address - Zip Code:07644-3324
Mailing Address - Country:US
Mailing Address - Phone:201-634-8755
Mailing Address - Fax:
Practice Address - Street 1:600 WINTERS AVE
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3904
Practice Address - Country:US
Practice Address - Phone:201-634-8755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00651500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor