Provider Demographics
NPI:1992338750
Name:CREVANI, DEVIN (DPT)
Entity type:Individual
Prefix:MR
First Name:DEVIN
Middle Name:
Last Name:CREVANI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:572 ELLIS RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08848-1563
Mailing Address - Country:US
Mailing Address - Phone:908-442-3250
Mailing Address - Fax:
Practice Address - Street 1:4901 LAC DE VILLE BLVD BLDG D
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-5647
Practice Address - Country:US
Practice Address - Phone:585-341-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-19
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT028341208100000X
NY0476872251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation