Provider Information for 1124879333
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DEBORAH KRAIDMAN
Sex: Female
NPI: 1124879333
Last Updated: 2024-05-03
Certification Date: 2024-05-03
Certification Date: 2024-05-03
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1124879333 | ||||||||||||
| Enumeration Date | 2024-03-27 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 10420 QUEENS BLVD APT 17L FOREST HILLS, NY 11375-3610 United States Phone: 718-490-8665 | Fax: | ||||||||||||
| Primary Practice Address | 1619 3RD AVE RM 202 NEW YORK, NY 10128-3459 United States Phone: 718-490-8665 | Fax: | ||||||||||||
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