Provider Demographics
NPI:1093770901
Name:CREMIN, PATRICIA (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:CREMIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23-00 RT 208 S
Mailing Address - Street 2:MAPLE AVE PEDIATRICS
Mailing Address - City:FAIRLAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410
Mailing Address - Country:US
Mailing Address - Phone:201-797-1900
Mailing Address - Fax:201-797-4457
Practice Address - Street 1:23-00 RT 208 S
Practice Address - Street 2:MAPLE AVE PEDIATRICS
Practice Address - City:FAIRLAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410
Practice Address - Country:US
Practice Address - Phone:201-797-1900
Practice Address - Fax:201-797-4457
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA55663208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics