Individual
TIMOTHY ROBERT KREIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7559 263RD ST, GLEN OAKS, NY 11004-1150
(718) 470-8303
(718) 470-1905
Mailing address
7559 263RD ST, GLEN OAKS, NY 11004-1150
(718) 470-8303
(718) 470-1905
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
MT198793
PA
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
275230-1
NY
390200000X
Student in an Organized Health Care Education/Training Program
MT198793
PA
Other
Enumeration date
04/12/2011
Last updated
11/16/2016
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