Provider Demographics
NPI:1255401584
Name:CRESCIONE, JOHN VITO (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:VITO
Last Name:CRESCIONE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 POST AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-4362
Mailing Address - Country:US
Mailing Address - Phone:516-338-1973
Mailing Address - Fax:516-338-1971
Practice Address - Street 1:55 POST AVE STE 204
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-4362
Practice Address - Country:US
Practice Address - Phone:516-338-1973
Practice Address - Fax:516-338-1971
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX006264111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX43091Medicare PIN