Most Relevant Information
Provider Data
| NPI Number: | 1003178773 |
| Provider Name: | JOANNE DECRESENZO MSED |
| Entity Type: | Individual |
| Taxonomy Code: | 174400000X |
| Specialty: | Specialist |
| License Number: | 633242051 |
Most Important Dates
| Enumeration Date: | 06/08/2012 |
| Last Updated: | 06/08/2012 |
Provider Practice Location
89 FREMONT AVE
STATEN ISLAND
NY
103062433
Practice Location Phone/Fax
| Phone: | 3475646040 |
| Fax: |
Provider Mailing Location
89 FREMONT AVE
STATEN ISLAND
NY
103062433
Provider Mailing Phone/Fax
| Phone: | 3475646040 |
| Fax: |