Provider Demographics
NPI:1689927089
Name:CROCE, CAMARON NICOLE (OTR)
Entity Type:Individual
Prefix:
First Name:CAMARON
Middle Name:NICOLE
Last Name:CROCE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:CAMARON
Other - Middle Name:NICOLE
Other - Last Name:MULLARKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:944 STATE ROUTE 17K
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:NY
Mailing Address - Zip Code:12549
Mailing Address - Country:US
Mailing Address - Phone:845-457-2400
Mailing Address - Fax:845-457-8502
Practice Address - Street 1:944 STATE ROUTE 17K
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:NY
Practice Address - Zip Code:12549
Practice Address - Country:US
Practice Address - Phone:845-457-2400
Practice Address - Fax:845-457-8502
Is Sole Proprietor?:No
Enumeration Date:2012-10-23
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017834225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist