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Individual

DR. KRISHNA KRITHIVAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
743 BROADWAY, SOUTH PORTLAND, ME 04106-4419
(207) 799-3031
(207) 799-9005
Mailing address
743 BROADWAY, SOUTH PORTLAND, ME 04106-4419
(207) 799-3031
(207) 799-9005

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT 866
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1073773487
GROUP NPI
ME
01
1760441042
KRISHNA KRITHIVAS INDIVIDUAL NPI
ME
Enumeration date
03/23/2006
Last updated
04/21/2011
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