Provider Demographics
NPI:1649559055
Name:CRESCI, GAIL (PHD, RD, CNSD, LD)
Entity Type:Individual
Prefix:DR
First Name:GAIL
Middle Name:
Last Name:CRESCI
Suffix:
Gender:F
Credentials:PHD, RD, CNSD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CLEVELAND CLINIC
Mailing Address - Street 2:9500 EUCLID AVENUE, M17
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-445-8317
Mailing Address - Fax:216-444-9415
Practice Address - Street 1:CLEVELAND CLINIC
Practice Address - Street 2:9500 EUCLID AVENUE, M17
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-445-8317
Practice Address - Fax:216-444-9415
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-16
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD 6717133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH133VOOOOOXMedicaid
OH133VOOOOOXMedicaid
OH133VOOOOOXMedicare PIN
OH133V00000XMedicare UPIN