Provider Demographics
NPI:1952701138
Name:CRESPO-OCASIO, ADA (MASTERS DEGREE)
Entity Type:Individual
Prefix:
First Name:ADA
Middle Name:
Last Name:CRESPO-OCASIO
Suffix:
Gender:F
Credentials:MASTERS DEGREE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1385 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237-6009
Mailing Address - Country:US
Mailing Address - Phone:347-234-4616
Mailing Address - Fax:
Practice Address - Street 1:1385 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-6009
Practice Address - Country:US
Practice Address - Phone:347-234-4616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-25
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist