Provider Demographics
NPI:1679519011
Name:KRESS, SIDNEY (MD)
Entity Type:Individual
Prefix:DR
First Name:SIDNEY
Middle Name:
Last Name:KRESS
Suffix:
Gender:M
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:PO BOX 48270
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07101-4800
Mailing Address - Country:US
Mailing Address - Phone:201-818-9118
Mailing Address - Fax:
Practice Address - Street 1:530 NEW BRUNSWICK AVE
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-3674
Practice Address - Country:US
Practice Address - Phone:732-324-5348
Practice Address - Fax:732-324-4811
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02710200174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJXK5559OtherHEALTHNET #
NJ221494442OtherTAX ID#
NJ2406187000OtherAMERIHEALTH #
NJP3617802OtherOXFORD #
NJ15297OtherAMERIGROUP #
NJ60014828OtherHORIZON NJ HEALTH #
NJP00208292OtherRR MDCR #
NJ40963OtherUNIVERSITY HEALTH PLANS
NJ556266XJXMedicare PIN
NJ2406187000OtherAMERIHEALTH #
NJE13370Medicare UPIN