Provider Demographics
NPI:1316725880
Name:CRUSE, ELIZABETH LOUISE (PA-C)
Entity type:Individual
Prefix:MISS
First Name:ELIZABETH
Middle Name:LOUISE
Last Name:CRUSE
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:171 MONTROSS RD
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-4742
Mailing Address - Country:US
Mailing Address - Phone:914-715-5122
Mailing Address - Fax:
Practice Address - Street 1:2649 STRANG BLVD STE 305
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-2939
Practice Address - Country:US
Practice Address - Phone:914-721-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY030644-01363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant