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Individual
DR. JOHN WILLIAM CROTTY
Active
Individual
DR. JOHN WILLIAM CROTTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
815
NE
152WP0200X
Pediatric Optometrist
815
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
47-0610838
FEDERAL TAX I.D.
—
01
—
815
OPTOMETRY LICENSE
NE
01
—
MC0048745
CONTROLLED SUBSTANCE REGI
—
Enumeration date
09/09/2005
Last updated
12/03/2009
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