Provider Demographics
NPI:1669645560
Name:KRIEGMAN, AUDREY GAIL (MD)
Entity Type:Individual
Prefix:DR
First Name:AUDREY
Middle Name:GAIL
Last Name:KRIEGMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 BARCHESTER WAY
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-3705
Mailing Address - Country:US
Mailing Address - Phone:908-232-1403
Mailing Address - Fax:
Practice Address - Street 1:131 BARCHESTER WAY
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-3705
Practice Address - Country:US
Practice Address - Phone:908-232-1403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-11
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03345500208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice