Provider Demographics
NPI:1740207174
Name:KREYMAN, ROMAN (DC)
Entity Type:Individual
Prefix:
First Name:ROMAN
Middle Name:
Last Name:KREYMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 AVE P
Mailing Address - Street 2:SUITE A-2
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229
Mailing Address - Country:US
Mailing Address - Phone:718-376-7820
Mailing Address - Fax:718-376-7820
Practice Address - Street 1:2001 AVE P
Practice Address - Street 2:SUITE A-2
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229
Practice Address - Country:US
Practice Address - Phone:718-376-7820
Practice Address - Fax:718-376-7820
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14303111N00000X
NJ38MC00662600111N00000X
NYX010776-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
1740207174OtherINDIVIDUAL NPI
NY02560332Medicaid
1760178644OtherGROUP NPI