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General NPI Number Information
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NPI Number | 1396964094
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Entity Type | Individual
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Provider Name | JONATHAN KRIEGER PHD
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Gender | Male
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 08/07/2008
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Provider Practice Location Address
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Address Line | 401 MAIN STREET ROSENDALE FAMILY THERAPY CENTER
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City | ROSENDALE
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State | NY
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Zip | 12472-0202
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Country | US
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Telephone | 845-658-9760
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Fax |
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Provider Business Mailing Address
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Address Line | 75 SHARON LANE
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City | KINGSTON
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State | NY
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Zip | 12401-4440
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Country | US
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Telephone | 845-339-5075
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 010040
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 010040
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License Number State | NY
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