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General NPI Number Information
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NPI Number | 1124879333
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Entity Type | Individual
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Provider Name | DEBORAH KRAIDMAN
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Gender | Female
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Dates
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Enumeration Date | 03/27/2024
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Last Update Date | 05/03/2024
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Provider Practice Location Address
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Address Line | 1619 3RD AVE RM 202
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City | NEW YORK
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State | NY
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Zip | 10128-3459
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Country | US
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Telephone | 718-490-8665
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Fax |
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Provider Business Mailing Address
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Address Line | 10420 QUEENS BLVD APT 17L
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City | FOREST HILLS
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State | NY
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Zip | 11375-3610
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Country | US
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Telephone | 718-490-8665
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 002278
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | P118318
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License Number State |
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