Provider Demographics
NPI:1558404749
Name:CROWE, RICHARD A (RPT)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:A
Last Name:CROWE
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 HOWIE AVE
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02888-4827
Mailing Address - Country:US
Mailing Address - Phone:401-467-7932
Mailing Address - Fax:
Practice Address - Street 1:321 RHODE ISLAND AVE
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-2329
Practice Address - Country:US
Practice Address - Phone:508-675-2840
Practice Address - Fax:508-675-8032
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4920174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY69031Medicare ID - Type Unspecified