Provider Demographics
NPI:1639392178
Name:ADAMS, CRISPIN BARRY (PMAC)
Entity Type:Individual
Prefix:MR
First Name:CRISPIN
Middle Name:BARRY
Last Name:ADAMS
Suffix:
Gender:M
Credentials:PMAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 PARKVIEW RD
Mailing Address - Street 2:
Mailing Address - City:ELMSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10523-3819
Mailing Address - Country:US
Mailing Address - Phone:914-347-3954
Mailing Address - Fax:718-778-6462
Practice Address - Street 1:737 NOSTRAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-4263
Practice Address - Country:US
Practice Address - Phone:718-783-4780
Practice Address - Fax:718-778-6462
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3490211D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes211D00000XPodiatric Medicine & Surgery Service ProvidersAssistant, Podiatric