Provider Demographics
NPI:1023209236
Name:KURT R. CROWLEY, M.D., P.C.
Entity Type:Organization
Organization Name:KURT R. CROWLEY, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KURT
Authorized Official - Middle Name:R
Authorized Official - Last Name:CROWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-578-0155
Mailing Address - Street 1:266 LANCASTER AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-3256
Mailing Address - Country:US
Mailing Address - Phone:610-578-0155
Mailing Address - Fax:610-578-0156
Practice Address - Street 1:266 LANCASTER AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-3256
Practice Address - Country:US
Practice Address - Phone:610-578-0155
Practice Address - Fax:610-578-0156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD058769L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0470905000OtherINDEPENDENCE BLUE CROSS
PA680928OtherHIGHMARK BLUE SHIELD
PA0470905000OtherINDEPENDENCE BLUE CROSS