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NPI Code Detail

MEDICARE: MATHILDE AVITUS-CREPIN

MEDICARE: MATHILDE AVITUS-CREPIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistNY

General Provider Information

NPI Number : 1356168116
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATHILDE AVITUS-CREPIN
Provider Business Mailing Address
First Line : 5320 CLARENDON RD
Second Line :
City : BROOKLYN
State : NY
Zip : 11203-5333
Country : US
Telephone Number : 929-513-7501
Fax Number :
Provider Business Practice Location Address
First Line : 649 39TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11232-3101
Country : US
Telephone Number : 718-851-3300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2024
Last Update Date : 09/23/2024

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Directions to “ MATHILDE AVITUS-CREPIN ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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