Provider Demographics
NPI:1306828751
Name:CRESCENZO, DELFINO MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:DELFINO
Middle Name:MICHAEL
Last Name:CRESCENZO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DELFINO
Other - Middle Name:MICHAEL
Other - Last Name:CRESCENZO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:16150 92ND ST
Mailing Address - Street 2:
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-3428
Mailing Address - Country:US
Mailing Address - Phone:718-848-0475
Mailing Address - Fax:718-848-5830
Practice Address - Street 1:16150 92ND ST
Practice Address - Street 2:
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-3428
Practice Address - Country:US
Practice Address - Phone:718-848-0475
Practice Address - Fax:718-848-5830
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-18
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY137516207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00818731Medicaid
NY1306828750OtherNPI
NY00818731Medicaid
NY1306828750OtherNPI