Organization
I.E.S. MEDICAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORNELIA KRIEGER (PROVDER COORDINATOR)
(914) 328-8077
Entity
Organization
Contact information
Practice address
3804 31ST AVE, ASTORIA, NY 11103-3800
(914) 328-8077
(914) 328-6083
Mailing address
174 GRAND ST, WHITE PLAINS, NY 10601-4803
(914) 328-8077
(914) 328-6083
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
155050
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04527
GHI MEDICARE
NY
Enumeration date
07/20/2006
Last updated
04/23/2008
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