Individual
MRS. CLOVA E CRISP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPN
Contact information
Practice address
322 CASSA LOOP, HOLTSVILLE, NY 11742-2622
(631) 758-2414
Mailing address
322 CASSA LOOP, HOLTSVILLE, NY 11742-2622
(631) 758-2414
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
505112-1
NY
163WG0600X
Gerontology Registered Nurse
505112-1
NY
Other
Enumeration date
03/12/2008
Last updated
03/12/2008
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