Provider Demographics
NPI:1518464171
Name:CRIMMINS, JAMES
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:CRIMMINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5923 STRICKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-6435
Mailing Address - Country:US
Mailing Address - Phone:347-506-1000
Mailing Address - Fax:718-975-7755
Practice Address - Street 1:5923 STRICKLAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-6435
Practice Address - Country:US
Practice Address - Phone:347-506-1000
Practice Address - Fax:718-975-7755
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-10
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031402-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist