Provider Demographics
NPI:1992896492
Name:KRAV, VERONIKA (OD)
Entity type:Individual
Prefix:
First Name:VERONIKA
Middle Name:
Last Name:KRAV
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 N BROWNING AVE
Mailing Address - Street 2:
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670-1912
Mailing Address - Country:US
Mailing Address - Phone:212-262-1502
Mailing Address - Fax:212-262-1855
Practice Address - Street 1:1804 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1404
Practice Address - Country:US
Practice Address - Phone:212-262-1502
Practice Address - Fax:212-262-1855
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV006858152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06674Medicare ID - Type UnspecifiedGHI MEDICARE