Individual
MRS. THERESA CRAWFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
500 FAIRGROUND RD, WEST WINFIELD, NY 13491-2006
(315) 822-2843
Mailing address
500 FAIRGROUND RD, WEST WINFIELD, NY 13491-2006
(315) 822-2843
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
437534-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992832448
—
NY
Enumeration date
10/21/2011
Last updated
10/21/2011
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