Provider Demographics
NPI:1992924054
Name:CRUMMER, MADELEINE (MD)
Entity type:Individual
Prefix:DR
First Name:MADELEINE
Middle Name:
Last Name:CRUMMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:686 QUAKER RD
Mailing Address - Street 2:
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514-1505
Mailing Address - Country:US
Mailing Address - Phone:914-238-6286
Mailing Address - Fax:
Practice Address - Street 1:WESTCHESTER INSTITUTE FOR HUMAN DEVELOPMENT
Practice Address - Street 2:332 CEDARWOOD HALL
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595
Practice Address - Country:US
Practice Address - Phone:914-493-8157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1725362084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01511655Medicaid
NY01511655Medicaid
NYE44728Medicare UPIN