Provider Demographics
NPI:1972946697
Name:CROWLEY, CARMELLA
Entity Type:Individual
Prefix:MRS
First Name:CARMELLA
Middle Name:
Last Name:CROWLEY
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 1:91 CLIFFORD AVE
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NY
Mailing Address - Zip Code:10803-1702
Mailing Address - Country:US
Mailing Address - Phone:914-738-9377
Mailing Address - Fax:
Practice Address - Street 1:27 CRANE RD
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-4251
Practice Address - Country:US
Practice Address - Phone:914-472-4404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-11
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY076449573174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist