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General NPI Number Information
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NPI Number | 1992018360
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Entity Type | Organization
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Legal Business Name | FLAVIO CRISARI PHYSICIAN PC
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Dates
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Enumeration Date | 07/14/2010
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Last Update Date | 03/01/2011
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Provider Practice Location Address
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Address Line | 8533 FOREST PKWY
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City | WOODHAVEN
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State | NY
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Zip | 11421-1130
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Country | US
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Telephone | 718-441-3970
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Fax | 718-441-6291
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Provider Business Mailing Address
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Address Line | 8533 FOREST PKWY
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City | WOODHAVEN
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State | NY
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Zip | 11421-1130
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Country | US
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Telephone | 718-441-3970
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Fax | 718-441-6291
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. FLAVIO CRISARI
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Credential | MD
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Telephone | 718-441-3970
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 172573
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License Number State | NY
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