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General NPI Number Information
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NPI Number | 1548359896
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Entity Type | Individual
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Provider Name | JILL P CRANDALL MD
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Gender | Female
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 04/27/2012
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Provider Practice Location Address
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Address Line | MONTEFIORE MEDICAL PARK 1575 BLONDELL AVENUE
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City | BRONX
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State | NY
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Zip | 10461
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Country | US
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Telephone | 718-405-8260
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 MORRIS PARK AVE BELFER 701
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City | BRONX
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State | NY
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Zip | 10461-1900
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Country | US
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Telephone | 718-430-3765
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Fax | 718-430-8557
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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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 179995
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License Number State | NY
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