Provider Demographics
NPI:1790159648
Name:CAVE, CRYSTINA KAYLIN (PA-C)
Entity Type:Individual
Prefix:MS
First Name:CRYSTINA
Middle Name:KAYLIN
Last Name:CAVE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3329 BELGREEN RD APT 2
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19154-1445
Mailing Address - Country:US
Mailing Address - Phone:610-451-9377
Mailing Address - Fax:
Practice Address - Street 1:HOLY REDEEMER HOSPITAL
Practice Address - Street 2:1648 HUNTINGDON PIKE
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19046
Practice Address - Country:US
Practice Address - Phone:215-947-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-16
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOA003916363A00000X
PAMA057990363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant