Provider Demographics
NPI:1093158255
Name:MCGRORTY-CROTTS, ALISON BETH (MD)
Entity Type:Individual
Prefix:DR
First Name:ALISON
Middle Name:BETH
Last Name:MCGRORTY-CROTTS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ALISON
Other - Middle Name:BETH
Other - Last Name:MCGRORTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1711 GREEN ST
Mailing Address - Street 2:APT J
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-3982
Mailing Address - Country:US
Mailing Address - Phone:267-205-2153
Mailing Address - Fax:
Practice Address - Street 1:500 S BROAD ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-1613
Practice Address - Country:US
Practice Address - Phone:215-685-6790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAMD456196208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program