Provider Demographics
NPI:1710175054
Name:ANDREWS CRAMPE, IRENE SHIRLEY
Entity Type:Individual
Prefix:MRS
First Name:IRENE
Middle Name:SHIRLEY
Last Name:ANDREWS CRAMPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 MARCY AVENUE
Mailing Address - Street 2:
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901-2908
Mailing Address - Country:US
Mailing Address - Phone:631-727-3893
Mailing Address - Fax:631-727-3893
Practice Address - Street 1:329 MARCY AVE
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-2908
Practice Address - Country:US
Practice Address - Phone:631-727-3893
Practice Address - Fax:631-727-3893
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1393391163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01864915OtherRN PRIVATE PROVIDER