Provider Demographics
NPI:1992871818
Name:CRUSADE, ANN CAIN (RN, MS LAC)
Entity type:Individual
Prefix:MS
First Name:ANN
Middle Name:CAIN
Last Name:CRUSADE
Suffix:
Gender:F
Credentials:RN, MS LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 N GLENORA RD
Mailing Address - Street 2:
Mailing Address - City:DUNDEE
Mailing Address - State:NY
Mailing Address - Zip Code:14837-8839
Mailing Address - Country:US
Mailing Address - Phone:607-243-7072
Mailing Address - Fax:
Practice Address - Street 1:590 PRE EMPTION RD
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:NY
Practice Address - Zip Code:14456-1372
Practice Address - Country:US
Practice Address - Phone:315-789-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003337-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist