Provider Demographics
NPI:1467683557
Name:CRAWSHAW, MAURA (OD)
Entity Type:Individual
Prefix:DR
First Name:MAURA
Middle Name:
Last Name:CRAWSHAW
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:MAURA
Other - Middle Name:
Other - Last Name:MELVIN-CRAWSHAW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:2904 WILLOW STREET PIKE N
Mailing Address - Street 2:
Mailing Address - City:WILLOW STREET
Mailing Address - State:PA
Mailing Address - Zip Code:17584-9227
Mailing Address - Country:US
Mailing Address - Phone:717-464-7292
Mailing Address - Fax:717-391-1085
Practice Address - Street 1:2904 WILLOW STREET PIKE N
Practice Address - Street 2:
Practice Address - City:WILLOW STREET
Practice Address - State:PA
Practice Address - Zip Code:17584-9227
Practice Address - Country:US
Practice Address - Phone:717-464-7292
Practice Address - Fax:717-391-1085
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG003016152W00000X, 152W00000X
NJ27OM00081800152W00000X
NYTUV007426152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY177335OtherMEDICARE
NJ203095550OtherEYE HEALTH GROUP OF SPRINGFIELD, LLC