Provider Demographics
NPI:1861604548
Name:KRYZAK, THOMAS JOHN JR (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JOHN
Last Name:KRYZAK
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1367 WASHINGTON AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12206-1048
Mailing Address - Country:US
Mailing Address - Phone:518-489-2666
Mailing Address - Fax:185-489-5933
Practice Address - Street 1:430 BATH RD
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2637
Practice Address - Country:US
Practice Address - Phone:207-442-0350
Practice Address - Fax:207-442-0355
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2020-08-13
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Provider Licenses
StateLicense IDTaxonomies
MEMD21175207XS0114X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryGroup - Single Specialty