Provider Demographics
NPI:1669406492
Name:KRAWITZ, PAUL L (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:L
Last Name:KRAWITZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:825 E GATE BLVD STE 111
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-2136
Mailing Address - Country:US
Mailing Address - Phone:516-804-5200
Mailing Address - Fax:516-240-6540
Practice Address - Street 1:755 PARK AVENUE
Practice Address - Street 2:SUITE 100
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-3972
Practice Address - Country:US
Practice Address - Phone:631-223-0400
Practice Address - Fax:631-421-2689
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1667631207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
31228OtherVYTRA
CS631OtherOXFORD
NY06014967352Medicaid
NYW64251OtherGROUP MEDICARE
200796POtherHIP
0C5057OtherHEALTHNET
NYW64251OtherGROUP MEDICARE
31228OtherVYTRA