Provider Demographics
NPI:1114270170
Name:CROSS, EMILY ANN
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:ANN
Last Name:CROSS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:EMILY
Other - Middle Name:ANN
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:49 WIRELESS BLVD
Mailing Address - Street 2:170
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-3965
Mailing Address - Country:US
Mailing Address - Phone:631-382-7311
Mailing Address - Fax:631-382-7399
Practice Address - Street 1:49 WIRELESS BLVD
Practice Address - Street 2:170
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-3965
Practice Address - Country:US
Practice Address - Phone:631-382-7311
Practice Address - Fax:631-382-7399
Is Sole Proprietor?:No
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator