Provider Demographics
NPI:1194774000
Name:KREYMAN, INNA (LCSW)
Entity type:Individual
Prefix:
First Name:INNA
Middle Name:
Last Name:KREYMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HORIZON RD
Mailing Address - Street 2:APT 805
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-6507
Mailing Address - Country:US
Mailing Address - Phone:917-608-5126
Mailing Address - Fax:
Practice Address - Street 1:8419 BAY PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-3303
Practice Address - Country:US
Practice Address - Phone:718-238-9814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR058760-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNH0881Medicare ID - Type Unspecified