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Individual

MRS. ASHLEY DECRESCENZO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
400 PINE DR, BRIGHTWATERS, NY 11718-1810
(631) 741-2818
Mailing address
400 PINE DR, BRIGHTWATERS, NY 11718-1810
(631) 741-2818

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
397531101
NY
174400000X
Specialist
397636101
NY
174400000X
Specialist
Primary
688222121
NY

Other

Enumeration date
12/09/2012
Last updated
12/09/2012
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