Provider Demographics
NPI:1003074055
Name:DUCREPIN, NELLY (DPM)
Entity Type:Individual
Prefix:DR
First Name:NELLY
Middle Name:
Last Name:DUCREPIN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 WEIR ST
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-7607
Mailing Address - Country:US
Mailing Address - Phone:917-685-6441
Mailing Address - Fax:516-481-6306
Practice Address - Street 1:47 WEIR ST
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-7607
Practice Address - Country:US
Practice Address - Phone:917-685-6441
Practice Address - Fax:516-481-6306
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-27
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006345213ES0103X, 213EP1101X, 213ES0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine