Provider Demographics
NPI:1477552255
Name:CRESPO, OSCAR (MD)
Entity Type:Individual
Prefix:
First Name:OSCAR
Middle Name:
Last Name:CRESPO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AVE FERNANDEZ JUNCOS 1501 ESQ PAVIA
Mailing Address - Street 2:EDIF BETANCOURT SUITE 101
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00910
Mailing Address - Country:US
Mailing Address - Phone:787-268-6736
Mailing Address - Fax:787-727-4045
Practice Address - Street 1:AVE FERNANDEZ JUNCOS CALLE EUROPA
Practice Address - Street 2:EDIF BETANCOURT 1501 SUITE 101
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00910
Practice Address - Country:US
Practice Address - Phone:787-268-6736
Practice Address - Fax:787-727-4045
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR11391247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG37222Medicare UPIN