Healthcare Provider Details

I. General information

NPI: 1306828751
Provider Name (Legal Business Name): DELFINO MICHAEL CRESCENZO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DELFINO MICHAEL CRESCENZO M.D.

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16150 92ND ST
HOWARD BEACH NY
11414-3428
US

IV. Provider business mailing address

16150 92ND ST
HOWARD BEACH NY
11414-3428
US

V. Phone/Fax

Practice location:
  • Phone: 718-848-0475
  • Fax: 718-848-5830
Mailing address:
  • Phone: 718-848-0475
  • Fax: 718-848-5830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number137516
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: