Provider Demographics
NPI:1497164214
Name:FREY, KRISTEL (PA)
Entity Type:Individual
Prefix:
First Name:KRISTEL
Middle Name:
Last Name:FREY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KRISTEL
Other - Middle Name:
Other - Last Name:DOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3737 MARKET ST
Mailing Address - Street 2:7TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5545
Mailing Address - Country:US
Mailing Address - Phone:215-662-3340
Mailing Address - Fax:215-222-8875
Practice Address - Street 1:3737 MARKET ST
Practice Address - Street 2:7TH FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-5545
Practice Address - Country:US
Practice Address - Phone:215-662-3340
Practice Address - Fax:215-222-8875
Is Sole Proprietor?:No
Enumeration Date:2014-08-06
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA056932363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant