Individual
CRYSTAL MCINTOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
199 ELMWOOD AVE, ROOSEVELT, NY 11575-1809
(516) 377-6304
Mailing address
199 ELMWOOD AVE, ROOSEVELT, NY 11575-1809
(516) 377-6304
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
713199
NY
164W00000X
Licensed Practical Nurse
299174
NY
Other
Enumeration date
11/11/2009
Last updated
03/25/2016
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