Provider Demographics
NPI:1275821555
Name:CHAPEL CRESPO, CRISTEL C
Entity Type:Individual
Prefix:
First Name:CRISTEL
Middle Name:C
Last Name:CHAPEL CRESPO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 191079
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-1079
Mailing Address - Country:US
Mailing Address - Phone:787-590-1772
Mailing Address - Fax:
Practice Address - Street 1:MANATI MEDICAL CENTER
Practice Address - Street 2:CALLE HERNANDEZ CARRION SUITE 204
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-621-3270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA149700207SG0201X
PR18749208000000X, 207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE