Provider Demographics
NPI:1033195003
Name:CRESPO DE CROMAR, MARIA CARIDAD (CNM)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:CARIDAD
Last Name:CRESPO DE CROMAR
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 BELLEVUE AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-4514
Mailing Address - Country:US
Mailing Address - Phone:609-394-4111
Mailing Address - Fax:609-394-4070
Practice Address - Street 1:433 BELLEVUE AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-4514
Practice Address - Country:US
Practice Address - Phone:609-384-4111
Practice Address - Fax:609-394-4070
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25ME00046600367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0204030Medicaid
NJ159903 M5NMedicare PIN
PAQ44820Medicare UPIN