Provider Demographics
NPI:1386713170
Name:KROHN, DOUGLAS L (MD)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:L
Last Name:KROHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:110 S BEDFORD RD
Mailing Address - Street 2:CARE MOUNT MEDICAL PC
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3446
Mailing Address - Country:US
Mailing Address - Phone:914-941-2129
Mailing Address - Fax:914-941-1969
Practice Address - Street 1:537 N STATE RD
Practice Address - Street 2:CARE MOUNT MEDICAL PC
Practice Address - City:BRIARCLIFF MANOR
Practice Address - State:NY
Practice Address - Zip Code:10510-1573
Practice Address - Country:US
Practice Address - Phone:914-941-2129
Practice Address - Fax:914-941-1969
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2016-11-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY219799208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02884260Medicaid
NYA400009174Medicare PIN