Provider Demographics
NPI:1306985098
Name:BRIEM, KRISTIN (PT)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:BRIEM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 ACADEMY ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-5101
Mailing Address - Country:US
Mailing Address - Phone:302-831-8667
Mailing Address - Fax:
Practice Address - Street 1:053 MCKINLY LAB
Practice Address - Street 2:UNIVERSITY OF DELAWARE
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19716-2590
Practice Address - Country:US
Practice Address - Phone:302-831-8893
Practice Address - Fax:302-831-4468
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0001845225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist