Individual provider Active NPI

Stephanie Erika Kreizman, ANP, GNP, RN

  • Nurse Practitioner
  • New York, NY
National Provider Identifier
1467895367
Registry record updated Apr 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F340895-1 Issued in NY
Practice address
525 E 68TH St
Baker 15
New York, NY 10065-4870
Phone
(646) 430-1569
NPI assigned
Apr 10, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F340895-1 NY Primary
Nurse Practitioner 363L00000X F30638-1 NY

Addresses

Primary practice location

525 E 68TH St
Baker 15
New York, NY 10065-4870

Mailing address

4 Carol CT
Pomona, NY 10970-2637
Phone (646) 430-1569

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
F30638-1NYMDNurse Practitioner
F340895-1NYMDNurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1365552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365552000000",
    "number": "1467895367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CAROL CT",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109702637",
            "telephone_number": "646-430-1569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E 68TH ST",
            "address_2": "BAKER 15",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654870",
            "telephone_number": "646-430-1569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREIZMAN",
        "first_name": "STEPHANIE",
        "middle_name": "ERIKA",
        "name_prefix": "Mrs.",
        "credential": "ANP, GNP, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-10",
        "last_updated": "2013-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F340895-1",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F30638-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.