Provider Demographics
NPI:1285764340
Name:CRISTO, WILLIAM NMN JR (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:NMN
Last Name:CRISTO
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:92 GRAPE ST STE 2A
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-2104
Mailing Address - Country:US
Mailing Address - Phone:508-984-5200
Mailing Address - Fax:508-659-5214
Practice Address - Street 1:92 GRAPE ST STE 2A
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-2104
Practice Address - Country:US
Practice Address - Phone:508-984-5200
Practice Address - Fax:508-659-5214
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2023-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA531382085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NOTDISCLOSEDOtherHARVARD PILGRAM HEALTH INS.
MA110064846AMedicaid
MAJ03417OtherBCBS OF MASS.
MAJ03417Medicare ID - Type Unspecified