Provider Demographics
NPI:1992886287
Name:KRIEGER, PAMELA JEAN (LDO)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:JEAN
Last Name:KRIEGER
Suffix:
Gender:F
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5507 NESCONSET HWY
Mailing Address - Street 2:
Mailing Address - City:MOUNT SINAI
Mailing Address - State:NY
Mailing Address - Zip Code:11766-2031
Mailing Address - Country:US
Mailing Address - Phone:631-474-1616
Mailing Address - Fax:631-474-2092
Practice Address - Street 1:5507 NESCONSET HWY
Practice Address - Street 2:
Practice Address - City:MOUNT SINAI
Practice Address - State:NY
Practice Address - Zip Code:11766-2031
Practice Address - Country:US
Practice Address - Phone:631-474-1616
Practice Address - Fax:631-474-2092
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT005594-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist