Provider Demographics
NPI:1346355765
Name:KREMS, SHELDON M (PHD)
Entity Type:Individual
Prefix:
First Name:SHELDON
Middle Name:M
Last Name:KREMS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 DAVIS AVENUE
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-2408
Mailing Address - Country:US
Mailing Address - Phone:845-485-3500
Mailing Address - Fax:845-485-8780
Practice Address - Street 1:510 HAIGHT AVENUE
Practice Address - Street 2:SUITE 102 SPECTRUM BEHAVIORAL MANAGEMENT SERV INC
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-2408
Practice Address - Country:US
Practice Address - Phone:845-485-3500
Practice Address - Fax:845-485-8780
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0053751103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
417561OtherMVP HEALTH CARE
027181OtherCDPHP
2112824OtherCIGNA BEH HEALTH
5417729OtherAETNA
1033150OtherBEACON HEALTH STRAT
000471040001OtherBSNENY
6886068OtherVALUE OPTIONS
6886068OtherGHI BMP
1033150OtherBEACON HEALTH STRAT
6886068OtherGHI BMP