Individual provider Active NPI

Stefan P. Kruszewski, M.D.

  • Legal Medicine
  • Harrisburg, PA
National Provider Identifier
1619096641
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
MD030879E Issued in PA
Practice address
133 Linglestown Rd
Harrisburg, PA 17110-1627
Phone
(717) 503-7862
Fax
(717) 599-5197
NPI assigned
Mar 29, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal Medicine 173000000X MD030879E PA Primary

Addresses

Primary practice location

133 Linglestown Rd
Harrisburg, PA 17110-1627

Mailing address

732 Forrest Rd
Harrisburg, PA 17112-9214
Phone (717) 599-5787

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD030879EPAMDLegal Medicine

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619096641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 FORREST RD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171129214",
            "telephone_number": "717-599-5787",
            "fax_number": "717-599-5197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 LINGLESTOWN RD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171101627",
            "telephone_number": "717-503-7862",
            "fax_number": "717-599-5197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSZEWSKI",
        "first_name": "STEFAN",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "PA",
            "license": "MD030879E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.