Healthcare Provider Details

I. General information

NPI: 1679409841
Provider Name (Legal Business Name): ELIZABETH CROPPER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 UNION AVE APT 1
WEST HAVEN CT
06516-5008
US

IV. Provider business mailing address

104 UNION AVE APT 1
WEST HAVEN CT
06516-5008
US

V. Phone/Fax

Practice location:
  • Phone: 203-645-6038
  • Fax: 203-645-6038
Mailing address:
  • Phone: 203-645-6038
  • Fax: 203-645-6038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number136375023
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: