Provider Demographics
NPI:1740207174
Name:KREYMAN, ROMAN (DC)
Entity type:Individual
Prefix:
First Name:ROMAN
Middle Name:
Last Name:KREYMAN
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 COLONIAL RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2525
Mailing Address - Country:US
Mailing Address - Phone:973-595-1809
Mailing Address - Fax:973-807-9355
Practice Address - Street 1:506 HAMBURG TPKE STE 202
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2069
Practice Address - Country:US
Practice Address - Phone:973-595-1809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14303111N00000X
NYX010776-1111N00000X
NJ38MC00662600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
1740207174OtherINDIVIDUAL NPI
NY02560332Medicaid
1760178644OtherGROUP NPI