Provider Demographics
NPI:1376564567
Name:FREINBERG-TRUFAS, CRISTI A (DDS)
Entity Type:Individual
Prefix:DR
First Name:CRISTI
Middle Name:A
Last Name:FREINBERG-TRUFAS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:658 COLUMBIA TPKE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:EAST GREENBUSH
Mailing Address - State:NY
Mailing Address - Zip Code:12061-2111
Mailing Address - Country:US
Mailing Address - Phone:518-477-2682
Mailing Address - Fax:518-477-2691
Practice Address - Street 1:658 COLUMBIA TPKE
Practice Address - Street 2:SUITE 3
Practice Address - City:EAST GREENBUSH
Practice Address - State:NY
Practice Address - Zip Code:12061-2111
Practice Address - Country:US
Practice Address - Phone:518-477-2682
Practice Address - Fax:518-477-2691
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0500301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY10068464-9312OtherCDPHP ID#
NY02388214Medicaid