Basic Information
| Provider Information | |||||||||
| NPI: | 1710987177 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KRIEBEL | ||||||||
| FirstName: | GEORGE | ||||||||
| MiddleName: | W | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 8019 | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011028000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8664314077 | ||||||||
| FaxNumber: | 4137747448 | ||||||||
| Practice Location | |||||||||
| Address1: | 70 MAIN ST | ||||||||
| Address2: | NORTHAMPTON HEALTH CENTER | ||||||||
| City: | FLORENCE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010621466 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135868400 | ||||||||
| FaxNumber: | 4135855491 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2005 | ||||||||
| LastUpdateDate: | 06/17/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 51510 | MA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 1293423 | 01 | MA | FALLON | OTHER | J08426 | 01 | MA | BLUE CROSS & BLUE SHIELD | OTHER | 13691 | 01 | MA | HEALTH NEW ENGLAND | OTHER | 3045641 | 05 | MA | MEDICAID | IP324749 | 01 | MA | MAGELLAN | OTHER | 051510 | 01 | MA | TUFTS | OTHER | 2034133 | 01 | MA | CIGNA BEHAVIORAL HEALTH | OTHER |