Provider Demographics
NPI:1760615058
Name:CRAWFORD, STEVEN J (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:J
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 QUAKER LN
Mailing Address - Street 2:
Mailing Address - City:SELDEN
Mailing Address - State:NY
Mailing Address - Zip Code:11784-1209
Mailing Address - Country:US
Mailing Address - Phone:631-903-4308
Mailing Address - Fax:
Practice Address - Street 1:4 QUAKER LN
Practice Address - Street 2:
Practice Address - City:SELDEN
Practice Address - State:NY
Practice Address - Zip Code:11784-1209
Practice Address - Country:US
Practice Address - Phone:631-903-4308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-02
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY576345163WG0600X, 163WR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation