Individual
MR. JOHN CRISPINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4665 AMBOY RD, STATEN ISLAND, NY 10312-4152
(718) 356-9826
(718) 966-1594
Mailing address
250 BAYVIEW AVE, STATEN ISLAND, NY 10309-3636
(718) 966-6175
(718) 966-1594
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N003913
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0008386
GHI
NY
01
—
480033373
RR MEDICARE
NY
Enumeration date
11/28/2005
Last updated
04/15/2011
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