Individual
BRENDA L CROWDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 HOSPITAL DR, MASSENA, NY 13662
(315) 764-1711
Mailing address
20 SUNSET DRIVE, RR #1, PRESCOTT, ONTARIO K0E 1-T0
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
022534
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/15/2018
Last updated
08/21/2018
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