Provider Demographics
NPI:1285243766
Name:CRAWLEY, MEGAN GAYLE (ATC)
Entity type:Individual
Prefix:MISS
First Name:MEGAN
Middle Name:GAYLE
Last Name:CRAWLEY
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:376 LAKEFRONT BLVD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14202-4319
Mailing Address - Country:US
Mailing Address - Phone:716-912-6787
Mailing Address - Fax:
Practice Address - Street 1:505 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14202-1309
Practice Address - Country:US
Practice Address - Phone:716-856-5192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0020552255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer