Individual
HALSEY CRUICKSHANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
1276 FULTON AVE, BRONX, NY 10456-3402
(718) 901-8792
(718) 901-8799
Mailing address
1431 E 108TH ST, SUITE D, BROOKLYN, NY 11236-4666
(718) 763-5093
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
003540
NY
Other
Enumeration date
10/19/2006
Last updated
07/08/2007
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