Individual
FREDRIC A KRISTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
29 FRANKLIN ST, BANGOR, ME 04401-4909
(207) 942-3816
(207) 561-4725
Mailing address
29 FRANKLIN ST, BANGOR, ME 04401-4909
(207) 942-3816
(207) 561-4725
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS925
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
098303
ANTHEM LEGACY NUMBER
ME
05
—
223490099
—
ME
Enumeration date
06/07/2006
Last updated
05/04/2021
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