Provider Demographics
NPI:1548359896
Name:CRANDALL, JILL P (MD)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:P
Last Name:CRANDALL
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1300 MORRIS PARK AVE
Mailing Address - Street 2:BELFER 701
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1900
Mailing Address - Country:US
Mailing Address - Phone:718-430-3765
Mailing Address - Fax:718-430-8557
Practice Address - Street 1:MONTEFIORE MEDICAL PARK
Practice Address - Street 2:1575 BLONDELL AVENUE
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-405-8260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2012-04-27
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Provider Licenses
StateLicense IDTaxonomies
NY179995207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism