Provider Demographics
NPI:1497817522
Name:CROWLEY, CHRISTINE PATRICIA (RN)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:PATRICIA
Last Name:CROWLEY
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 1:246 NEW HYDE PARK RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-2326
Mailing Address - Country:US
Mailing Address - Phone:516-775-5693
Mailing Address - Fax:516-775-5694
Practice Address - Street 1:246 NEW HYDE PARK RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-2326
Practice Address - Country:US
Practice Address - Phone:516-775-5693
Practice Address - Fax:516-775-5694
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY463903-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02551577Medicaid