Provider Demographics
NPI:1689690752
Name:CROWLEY, TIMOTHY F (DC)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:F
Last Name:CROWLEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 COLLEGE DR
Mailing Address - Street 2:#6
Mailing Address - City:CLEMENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08021
Mailing Address - Country:US
Mailing Address - Phone:856-782-9500
Mailing Address - Fax:856-782-1077
Practice Address - Street 1:2001 COLLEGE DR
Practice Address - Street 2:#6
Practice Address - City:CLEMENTON
Practice Address - State:NJ
Practice Address - Zip Code:08021
Practice Address - Country:US
Practice Address - Phone:856-782-9500
Practice Address - Fax:856-782-1077
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC04168111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
0662686000OtherAMERIHEALTH
938873OtherAETNA
1054080OtherUNITED
CR65809Medicare ID - Type Unspecified
0662686000OtherAMERIHEALTH