Provider Demographics
NPI:1225149982
Name:AUSTIN, CRAIG (MD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:
Last Name:AUSTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 WESTAGE BUSINESS CTR DR
Mailing Address - Street 2:SUITE 231
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524-2264
Mailing Address - Country:US
Mailing Address - Phone:845-896-6669
Mailing Address - Fax:845-896-2854
Practice Address - Street 1:200 WESTAGE BUSINESS CTR DR
Practice Address - Street 2:SUITE 231
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-2264
Practice Address - Country:US
Practice Address - Phone:845-896-6669
Practice Address - Fax:845-896-2854
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1702401207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0026638OtherGHI
NYCA022E3110OtherEMPIRE BCBS
P778084OtherOXFORD
1C6098OtherHEALTHNET
A61329Medicare UPIN
P778084OtherOXFORD
NY22E311Medicare PIN