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General NPI Number Information
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NPI Number | 1467895367
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Entity Type | Individual
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Provider Name | STEPHANIE ERIKA KREIZMAN ANP, GNP, RN
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Gender | Female
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Dates
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Enumeration Date | 04/10/2013
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Last Update Date | 04/10/2013
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Provider Practice Location Address
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Address Line | 525 E 68TH ST BAKER 15
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City | NEW YORK
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State | NY
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Zip | 10065-4870
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Country | US
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Telephone | 646-430-1569
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Fax |
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Provider Business Mailing Address
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Address Line | 4 CAROL CT
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City | POMONA
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State | NY
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Zip | 10970-2637
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Country | US
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Telephone | 646-430-1569
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | F340895-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | F30638-1
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License Number State | NY
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