Provider Demographics
NPI:1598979130
Name:KREIG, KRISTIN S (PTA)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:S
Last Name:KREIG
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 FAIRVIEW AVENUE
Mailing Address - Street 2:STOP #10
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534
Mailing Address - Country:US
Mailing Address - Phone:518-249-1248
Mailing Address - Fax:
Practice Address - Street 1:71 PROSPECT AVENUE
Practice Address - Street 2:COLUMBIA MEMORIAL HOSPITAL
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534
Practice Address - Country:US
Practice Address - Phone:518-828-8206
Practice Address - Fax:518-828-8094
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0060861225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant