# OWEN MCCRUDDEN DPM, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295877116
- **Authorized official:** DR. OWEN JAMES MCCRUDDEN DPM (PODIATRIST)
- **Authorized official phone:** (516) 496-0900

## Contact information

- **Practice address:** 8029 JERICHO TPKE, WOODBURY, NY 11797
- **Practice address phone:** (516) 496-0900
- **Practice address fax:** (516) 496-0901
- **Mailing address:** 8029 JERICHO TPKE, WOODBURY, NY 11797
- **Mailing address phone:** (516) 496-0900
- **Mailing address fax:** (516) 496-0901

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 5928-1 | NY | Yes |

## Other

- **Enumeration date:** 02/14/2007
- **Last updated:** 12/03/2008