Healthcare Provider Details

I. General information

NPI: 1386364628
Provider Name (Legal Business Name): JENNIFER KIT KREIGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2022
Last Update Date: 08/29/2022
Certification Date: 08/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 US HIGHWAY 46 STE 420
FAIRFIELD NJ
07004-1532
US

IV. Provider business mailing address

117 SAINT LOUIS AVE
POINT PLEASANT BEACH NJ
08742-2673
US

V. Phone/Fax

Practice location:
  • Phone: 973-882-3456
  • Fax:
Mailing address:
  • Phone: 908-783-4958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: