Provider Demographics
NPI:1215364765
Name:CROWLEY, PAUL M (MS)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:M
Last Name:CROWLEY
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 TAMARACK ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14220-1731
Mailing Address - Country:US
Mailing Address - Phone:716-364-3643
Mailing Address - Fax:
Practice Address - Street 1:1325 MAIN ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14209-1988
Practice Address - Country:US
Practice Address - Phone:716-364-3643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-30
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health