Provider Demographics
NPI:1376809160
Name:MCCRIMMON, ALICE (RN)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:
Last Name:MCCRIMMON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 E 23RD ST ROOM 118
Mailing Address - Street 2:347 ASL & ENG SCHOOL
Mailing Address - City:NY
Mailing Address - State:NY
Mailing Address - Zip Code:10010
Mailing Address - Country:US
Mailing Address - Phone:917-817-9771
Mailing Address - Fax:
Practice Address - Street 1:225 E 23RD ST ROOM 118
Practice Address - Street 2:347 ASL & ENG SCHOOL
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10010
Practice Address - Country:US
Practice Address - Phone:917-817-9771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-05
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY269400-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool