Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 026824 | NY |
NPI | 1023394582 |
---|---|
Provider Name | Miss Ashley M Krupski |
First Address | Orchard Park, NY 14127-2117 |
Second Address | Lackawanna, NY 14218-1629 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2011 |
Last Update Date | 28/10/2011 |