Provider Demographics
NPI:1215501465
Name:CROWLEY NURSE PRACTITIONER IN FAMILY HEALTH, PLLC
Entity type:Organization
Organization Name:CROWLEY NURSE PRACTITIONER IN FAMILY HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PA
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:CROWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:518-886-8066
Mailing Address - Street 1:2 PATRICIA LN
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-2812
Mailing Address - Country:US
Mailing Address - Phone:518-646-1971
Mailing Address - Fax:
Practice Address - Street 1:2 FRANKLIN SQ STE F
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-2262
Practice Address - Country:US
Practice Address - Phone:518-646-1971
Practice Address - Fax:949-543-2822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-13
Last Update Date:2023-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty