Provider Demographics
NPI:1922883206
Name:CRUMP, TASHA YVETTE (RDMS)
Entity Type:Individual
Prefix:
First Name:TASHA
Middle Name:YVETTE
Last Name:CRUMP
Suffix:
Gender:F
Credentials:RDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:644 SILVER LAKE SCOTCHTOWN RD APT 18F
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-1523
Mailing Address - Country:US
Mailing Address - Phone:845-394-0095
Mailing Address - Fax:
Practice Address - Street 1:90 NORTH ST STE 207
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-5360
Practice Address - Country:US
Practice Address - Phone:845-394-0095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-25
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1202012085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound