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General NPI Number Information
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NPI Number | 1740302231
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Entity Type | Individual
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Provider Name | DIANA A CRESPO CPHT
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Gender | Female
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 300 LONGWOOD AVE
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City | BOSTON
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State | MA
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Zip | 02115-5724
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Country | US
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Telephone | 617-355-6810
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Fax |
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Provider Business Mailing Address
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Address Line | 65 COLCHESTER ST
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City | READVILLE
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State | MA
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Zip | 02136-2340
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Country | US
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Telephone | 617-364-0905
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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 | 924
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License Number State | MA
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