Provider Demographics
NPI:1265017107
Name:CROSLEY, PHILIP ANDREW (FNP-BC)
Entity Type:Individual
Prefix:MR
First Name:PHILIP ANDREW
Middle Name:
Last Name:CROSLEY
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 RED MILLS RD
Mailing Address - Street 2:
Mailing Address - City:WALLKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12589-3220
Mailing Address - Country:US
Mailing Address - Phone:845-744-9105
Mailing Address - Fax:
Practice Address - Street 1:800 RED MILLS RD
Practice Address - Street 2:
Practice Address - City:WALLKILL
Practice Address - State:NY
Practice Address - Zip Code:12589-3220
Practice Address - Country:US
Practice Address - Phone:845-744-9105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-12
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01129400363LF0000X
NY347450363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily