Individual
MR. PAUL KRIEGSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
618 ELMIRA RD, ITHACA, NY 14850-8745
(607) 588-8888
(607) 697-0489
Mailing address
618 ELMIRA RD, ITHACA, NY 14850-8745
(607) 588-8888
(607) 697-0489
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
280075992
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03348318
—
NY
Enumeration date
04/28/2016
Last updated
04/28/2016
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