Doctor Name: | DR. JOHN ANTHONY KRUG |
NPI Number: | 1053444513 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSY.D. |
License Number: | 35SI00260200 |
Business Practice Address: | 465 Ogden Ave Teaneck, NJ - 076662820 |
Business Phone Number: | 2018378617 |
Business Fax Number: | 2018454941 |
Mailing Address: | 465 Ogden Ave, TEANECK |
State: | NJ |
Postal Code: | 076662820 |
Phone Number: | 2018378617 |
Fax Number: | 2018454941 |
NPI Enumeration Date: | 03/13/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 35SI00260200 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |