Individual provider Active NPI

Robert A. Krackow, D.D.S.

  • Prosthodontics
  • New York, NY
National Provider Identifier
1841314259
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
037039 Issued in NY
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

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
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

LicenseStateTypeSpecialty
037039NYMDProsthodontist

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.

Verify at the official NPI Registry.