Provider Demographics
NPI:1316999303
Name:KRENITSKY, HAYOSH & ASSOCIATES, P.C.
Entity type:Organization
Organization Name:KRENITSKY, HAYOSH & ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:KRENITSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:586-758-7880
Mailing Address - Street 1:13251 E 10 MILE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48089-2076
Mailing Address - Country:US
Mailing Address - Phone:586-758-7880
Mailing Address - Fax:
Practice Address - Street 1:13251 E 10 MILE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48089-2076
Practice Address - Country:US
Practice Address - Phone:586-758-7880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOEO6137OtherBCBS OF MICHIGAN
MIOEO6137OtherBCBS OF MICHIGAN