Basic Information
Provider Information
NPI: 1518928613
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HRISTEA
FirstName: BRIGITTE
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 10187
Address2:  
City: ALBANY
State: NY
PostalCode: 122015187
CountryCode: US
TelephoneNumber: 2077774111
FaxNumber: 2077836660
Practice Location
Address1: 100 CAMPUS AVENUE
Address2: SUITE 208
City: LEWISTON
State: ME
PostalCode: 04240
CountryCode: US
TelephoneNumber: 2077778974
FaxNumber: 2077778946
Other Information
ProviderEnumerationDate: 03/29/2006
LastUpdateDate: 07/22/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X227284MAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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