MEDICARE: LOREN CROWLEY CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	645830	NY

General Provider Information

NPI Number	:	1689122087
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOREN CROWLEY CRNA

Provider Business Mailing Address
First Line	:	107 CLEVELAND AVE
Second Line	:	APARTMENT 1
City	:	LONG BEACH
State	:	NY
Zip	:	11561-3810
Country	:	US
Telephone Number	:	516-729-9322
Fax Number	:

Provider Business Practice Location Address
First Line	:	107 CLEVELAND AVE
Second Line	:	APARTMENT 1
City	:	LONG BEACH
State	:	NY
Zip	:	11561-3810
Country	:	US
Telephone Number	:	516-729-9322
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2016
Last Update Date	:	08/03/2017

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Directions to “ LOREN CROWLEY CRNA” Practice Location

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