Individual provider Active NPI

Halina Krutak Krol, MD, LLC

  • Nephrology Physician
  • Clifton, NJ
National Provider Identifier
1619063922
Registry record updated Nov 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
25MA05177800 Issued in NJ
Practice address
164 Brighton Road
Clifton, NJ 07012
Phone
(973) 777-9950
Fax
(973) 778-2763
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 25MA05177800 NJ Primary

Addresses

Primary practice location

164 Brighton Road
Clifton, NJ 07012

Mailing address

164 Brighton Road
Clifton, NJ 07012
Phone (973) 777-9950

Other identifiers 1

IdentifierTypeStateIssuer
3435601MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352160000000",
    "number": "1619063922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 BRIGHTON ROAD",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "07012",
            "telephone_number": "973-777-9950",
            "fax_number": "973-778-2763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 BRIGHTON ROAD",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "07012",
            "telephone_number": "973-777-9950",
            "fax_number": "973-778-2763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROL",
        "first_name": "HALINA",
        "middle_name": "KRUTAK",
        "name_prefix": "Mrs.",
        "credential": "MD, LLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2012-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "25MA05177800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3435601",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.