Organization
GUY G. CREVECOEUR, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUZIE ASHJIAN (CRED MANAGER)
(914) 437-5850
Entity
Organization
Contact information
Practice address
95-25 QUEENS BLVD, REGO PARK, NY 11374
(718) 896-4399
Mailing address
20 MAPLE AVE, ARMONK, NY 10504-1836
(914) 437-5850
(914) 437-5849
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
182078
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01580914
—
NY
Enumeration date
03/23/2007
Last updated
07/31/2007
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