Healthcare Provider Details

I. General information

NPI: 1356840979
Provider Name (Legal Business Name): KRISTIN M. KREIDER ACNP, RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2018
Last Update Date: 05/22/2023
Certification Date: 05/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 E 70TH ST
NEW YORK NY
10021-4898
US

IV. Provider business mailing address

1709 STERLING DR
FLORHAM PARK NJ
07932-3036
US

V. Phone/Fax

Practice location:
  • Phone: 212-606-1000
  • Fax:
Mailing address:
  • Phone: 732-668-4924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number26NR13779800
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number431645
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: