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Organization

CROWN ACO LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEVENDRA SHRIVASTAVA (AUTHORIZED OFFICIAL)
(718) 552-2070
Entity
Organization

Contact information

Practice address
1545 ATLANTIC AVE STE 108, BROOKLYN, NY 11213-1122
(718) 552-2070
Mailing address
15 WOODCREST DR, SYOSSET, NY 11791-3036
(718) 552-2070

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
08/06/2025
Last updated
08/06/2025
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