Basic Information
| Provider Information | |||||||||
| NPI: | 1275821555 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHAPEL CRESPO | ||||||||
| FirstName: | CRISTEL | ||||||||
| MiddleName: | C | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 191079 | ||||||||
| Address2: | |||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009191079 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7875901772 | ||||||||
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| Practice Location | |||||||||
| Address1: | MANATI MEDICAL CENTER | ||||||||
| Address2: | CALLE HERNANDEZ CARRION SUITE 204 | ||||||||
| City: | MANATI | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00674 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7876213270 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2011 | ||||||||
| LastUpdateDate: | 11/08/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207SG0201X | A149700 | CA | N | Allopathic & Osteopathic Physicians | Medical Genetics | Clinical Genetics (M.D.) | 208000000X | 18749 | PR | N | Allopathic & Osteopathic Physicians | Pediatrics | 207SG0201X | 18749 | PR | Y | Allopathic & Osteopathic Physicians | Medical Genetics | Clinical Genetics (M.D.) |
ID Information
| ID | Type | State | Issuer | Description | NONE | 01 | NONE | OTHER |