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Organization
OMNICARE PLUS, PC
Active
Organization
OMNICARE PLUS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVANS CREVECOEUR M.D. (ANESTHESIOLOGIST)
(718) 622-0111
Entity
Organization
Contact information
Practice address
23428 MERRICK BLVD, 2ND FL, ROSEDALE, NY 11422-1320
(718) 636-3990
(718) 636-5140
Mailing address
55 GREENE AVE, SUITE LLA, BROOKLYN, NY 11238-1026
(718) 622-0111
(718) 636-5140
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
177953
NY
Other
Enumeration date
08/05/2009
Last updated
08/05/2009
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