Provider Demographics
NPI:1134371313
Name:CROWN THERAPISTS INC
Entity type:Organization
Organization Name:CROWN THERAPISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:AIGBOGUN
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:609-463-9553
Mailing Address - Street 1:9 STITES AVE
Mailing Address - Street 2:PO BOX 874
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-2267
Mailing Address - Country:US
Mailing Address - Phone:609-463-9553
Mailing Address - Fax:609-463-9540
Practice Address - Street 1:9 STITES AVE
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-2267
Practice Address - Country:US
Practice Address - Phone:609-463-9553
Practice Address - Fax:609-463-9540
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CROWN THERAPISTS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00220900225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
58001OtherCIGNA
1602584OtherAMERIHEALTH
NJDD2634OtherRAILROAD MEDICARE
NJ075204OtherMEDICARE