Provider Demographics
NPI:1992227912
Name:KREYDIN, INNA (OD)
Entity type:Individual
Prefix:DR
First Name:INNA
Middle Name:
Last Name:KREYDIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 MONTFORT DR
Mailing Address - Street 2:
Mailing Address - City:BELLE MEAD
Mailing Address - State:NJ
Mailing Address - Zip Code:08502-4805
Mailing Address - Country:US
Mailing Address - Phone:908-672-0892
Mailing Address - Fax:
Practice Address - Street 1:110 E 40TH ST RM 601
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-1820
Practice Address - Country:US
Practice Address - Phone:212-490-3937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-11
Last Update Date:2017-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008647152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist