Active NPI
Robert A. Krackow, D.D.S.
- Prosthodontics
- New York, NY
National Provider Identifier
1841314259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 037039
- Practice address
- 509 Madison Ave
Suite 1716
New York, NY 10022-5501 - Phone
- (212) 752-7536
- Fax
- (212) 752-7723
- NPI assigned
- Mar 19, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 037039 | NY | Primary |
Addresses
Primary practice location
509 Madison Ave
Suite 1716
New York, NY 10022-5501
Mailing address
509 Madison Avenue
Suite 1716
New York, NY 10022-5527
Phone (212) 752-7536
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 037039 | NY | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1841314259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "509 MADISON AVENUE",
"address_2": "SUITE 1716",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100225527",
"telephone_number": "212-752-7536",
"fax_number": "212-752-7723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "509 MADISON AVE",
"address_2": "SUITE 1716",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100225501",
"telephone_number": "212-752-7536",
"fax_number": "212-752-7723"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRACKOW",
"first_name": "ROBERT",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "NY",
"license": "037039",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
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.