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General NPI Number Information
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NPI Number | 1932654456
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Entity Type | Individual
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Provider Name | ABIGAIL CRESCITELLI MS, LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 08/25/2016
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Last Update Date | 08/23/2021
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Provider Practice Location Address
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Address Line | 5151 PARK AVE
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City | FAIRFIELD
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State | CT
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Zip | 06825-1000
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Country | US
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Telephone | 203-371-7999
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Fax | 203-365-4704
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Provider Business Mailing Address
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Address Line | 38 CAROLYN ST
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City | FLORENCE
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State | MA
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Zip | 01062-1062
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Country | US
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Telephone | 413-588-4981
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT1570
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 001599
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License Number State | CT
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