Provider Demographics
NPI:1871646646
Name:KREIGER, PORTIA A (MD)
Entity Type:Individual
Prefix:DR
First Name:PORTIA
Middle Name:A
Last Name:KREIGER
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 1:3400 CIVIC CENTER BLDG
Mailing Address - Street 2:MAIN BLDG - 5TH FLR - ROOM 5130
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:215-590-2266
Mailing Address - Fax:215-590-2171
Practice Address - Street 1:3400 CIVIC CENTER BLDG
Practice Address - Street 2:MAIN BLDG - 5TH FLR - ROOM 5130
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-590-2266
Practice Address - Fax:215-590-2171
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD425208174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist