Provider Demographics
NPI:1487629168
Name:KRUGER, PHILIP BARRY (OD, PHD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:BARRY
Last Name:KRUGER
Suffix:
Gender:M
Credentials:OD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E 34TH ST
Mailing Address - Street 2:APARTMENT 10K
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4976
Mailing Address - Country:US
Mailing Address - Phone:212-486-5579
Mailing Address - Fax:
Practice Address - Street 1:300 E 34TH ST
Practice Address - Street 2:APARTMENT 10K
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4976
Practice Address - Country:US
Practice Address - Phone:212-486-5579
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT003511-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist