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General NPI Number Information
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NPI Number | 1891026704
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Entity Type | Individual
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Provider Name | KELLY S KREIDER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 01/18/2010
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Last Update Date | 05/23/2022
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Provider Practice Location Address
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Address Line | 185 GREENWICH ST # LL5155
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City | NEW YORK
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State | NY
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Zip | 10007-2383
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Country | US
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Telephone | 646-822-4717
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Fax | 212-822-4718
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Provider Business Mailing Address
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Address Line | 120 THOMPSON ST APT 16
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City | NEW YORK
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State | NY
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Zip | 10012-3721
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Country | US
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Telephone |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | S017406
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 060219
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License Number State | NY
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