Provider Demographics
NPI:1508585498
Name:CROCE, HANNAH ROSE
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:ROSE
Last Name:CROCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 MONTAUK HWY
Mailing Address - Street 2:
Mailing Address - City:EAST MORICHES
Mailing Address - State:NY
Mailing Address - Zip Code:11940-1346
Mailing Address - Country:US
Mailing Address - Phone:631-599-8346
Mailing Address - Fax:
Practice Address - Street 1:416 MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:EAST MORICHES
Practice Address - State:NY
Practice Address - Zip Code:11940-1346
Practice Address - Country:US
Practice Address - Phone:631-363-1980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer