Individual
KEVIN J KRIESEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
826 WASHINGTON ST FL 3, WATERTOWN, NY 13601-4064
(315) 788-1751
(315) 788-9021
Mailing address
826 WASHINGTON ST FL 3, WATERTOWN, NY 13601-4064
(315) 788-1751
(315) 788-9021
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
329201
NY
207Y00000X
Otolaryngology Physician
L3721
TX
207Y00000X
Otolaryngology Physician
MD457864
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040017071
—
TX
05
—
151036401
—
TX
05
—
151036402
—
TX
05
—
151036403
—
TX
Enumeration date
07/29/2006
Last updated
09/09/2024
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