DR. DAVID KREDITOR


Address: 242 Eat 19th Street, Suite #3, New York, NY 10003
Phone: 2123532222

DR. DAVID KREDITOR (NPI# 1154414621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1154414621
Entity Type Individual
Full Name DR. DAVID KREDITOR
Credential M.D.
Practice Address 242 Eat 19th Street
Suite #3
New York
NY 10003
Mailing Address 530f Grand St
Apt 10b
New York
NY 10002-4271
Practice Telephone 2123532222
Practice Fax Number 2125339428
Mailing Telephone 2123531704
Mailing Fax Number 2125298039
Enumeration Date 2006-10-02
Last Update Date 2018-05-22
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 174400000X Specialist 197135 NY Other Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
NY DEA BK4278683 01
NY 01523591 05
NY LICENCE 197135 01

Office Location

Street Address 242 EAT 19TH STREET
SUITE #3
City NEW YORK
State NY
Zip Code 10003

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Taxonomy Information

Taxonomy Code 174400000X
Grouping Other Service Providers
Classification Specialist

Taxonomy Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974.

Providers in the same taxonomy and city

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1275148652 Gloria Li Specialist 959 1st Ave, New York, NY 10022-6649 2020-09-11
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1659995801 Theodore Nathan Raosen Specialist 128 Pinehurst Ave Apt B61, New York, NY 10033-1755 2020-06-03
1255954301 Courtney Foster Specialist 222 E 34th St # 13, New York, NY 10016-4842 2020-05-23
1396371852 Laquanique Louise Lake Specialist 116west 32nd Street, New York, NY 10001-3212 2020-03-17
1205460524 Yasmin El-hifnawi Cooper Specialist 2572 Frederick Douglass Blvd Unit B, New York, NY 10030-2106 2020-02-25
1376175992 Patricia Ann Ebert Specialist 310 E 102nd St Apt 9d, New York, NY 10029-5607 2020-02-11
1912547928 Roberto Manuel Gonzalez Specialist 250 W 108th St, New York, NY 10025-2956 2020-01-08
1659918639 Delores Cody Oppecker Specialist 455 Fort Washington Ave Apt 53, New York, NY 10033-4631 2019-12-09
1174160543 Jazmin Bernal Specialist 765 Riverside Dr, 3n, New York, NY 10032 2019-12-04
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Competitor

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City NEW YORK
Zip Code 10003

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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