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General NPI Number Information
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NPI Number | 1396903886
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Entity Type | Individual
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Provider Name | CRYSTAL MILLET ESCUDERO TECHNICIAN PHARMACIS
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Gender | Female
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Dates
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Enumeration Date | 05/30/2008
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Last Update Date | 05/30/2008
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Provider Practice Location Address
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Address Line | AVE GILBERTO CONCEPCION DE GRACIA 20 24 SIERRA BAYAMON
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City | BAYAMON
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State | PR
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Zip | 00964
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Country | US
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Telephone | 787-786-9610
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Fax |
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Provider Business Mailing Address
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Address Line | 49 CALLE JOSE JULIAN ACOSTA
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City | VEGA BAJA
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State | PR
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Zip | 00693-4436
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 6838
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License Number State | PR
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