Basic Information
| Provider Information | |||||||||
| NPI: | 1336147123 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KREIDER | ||||||||
| FirstName: | CHAD | ||||||||
| MiddleName: | MICHAEL | ||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2775 SCHOENERSVILLE RD | ||||||||
| Address2: | |||||||||
| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180177307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108618080 | ||||||||
| FaxNumber: | 6108070366 | ||||||||
| Practice Location | |||||||||
| Address1: | 2775 SCHOENERSVILLE RD | ||||||||
| Address2: | |||||||||
| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180177307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108618080 | ||||||||
| FaxNumber: | 6108070366 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2005 | ||||||||
| LastUpdateDate: | 01/29/2008 | ||||||||
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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 | 225100000X | PT013550L | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 03170001 | 01 | KEYSTONE HEALTH CENTRAL | OTHER | 0440624000 | 01 | KEYSTONE HEALTH EAST | OTHER | 5008552 | 01 | CIGNA HEALTHCARE | OTHER | P21022995 | 01 | OXFORD HEALTH PLANS | OTHER | 811600 | 01 | FIRST PRIORITY HEALTH | OTHER | 0440624000 | 01 | INDEPENDENCE BLUE CROSS | OTHER | 0440624000 | 01 | AMERIHEALTH | OTHER | 643095 | 01 | HIGHMARK BLUE SHIELD | OTHER | 03170001 | 01 | CAPITAL BLUE CROSS | OTHER | 2201257 | 01 | UNITED HEALTHCARE | OTHER | 47241 | 01 | GEISINGER HEALTH PLAN | OTHER | 643095 | 01 | FIRST PRIORITY LIFE INS | OTHER | 2362601 | 01 | AETNA PPO | OTHER | 329117 | 01 | HEALTHAMERICA/HEALTHASSUR | OTHER |