Provider Demographics
NPI:1639199425
Name:CROHAN, CHRISTINE H (MSED)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:H
Last Name:CROHAN
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4011
Mailing Address - Country:US
Mailing Address - Phone:401-721-9229
Mailing Address - Fax:
Practice Address - Street 1:621 DEXTER ST
Practice Address - Street 2:
Practice Address - City:CENTRAL FALLS
Practice Address - State:RI
Practice Address - Zip Code:02863-2742
Practice Address - Country:US
Practice Address - Phone:401-721-9229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI292177OtherEIBLUECROSS
RI412296OtherEIBLUECHIP
RI2092OtherEINHPRC
RI6400144OtherEIUHP