Provider Demographics
NPI:1881626976
Name:KRUGER, BARBARA (PHD)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:
Last Name:KRUGER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 SOMERSET DR
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-1636
Mailing Address - Country:US
Mailing Address - Phone:631-543-5392
Mailing Address - Fax:631-543-7515
Practice Address - Street 1:37 SOMERSET DR
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-1636
Practice Address - Country:US
Practice Address - Phone:631-543-5392
Practice Address - Fax:631-543-7515
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY91231H00000X
NY1287235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYM01451Medicare UPIN