Healthcare Provider Details

I. General information

NPI: 1245934272
Provider Name (Legal Business Name): AYLIN SARA CRUGNALE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1123 N CHURCH ST
GREENSBORO NC
27401-1007
US

IV. Provider business mailing address

13540 HULL STREET RD
MIDLOTHIAN VA
23112-2107
US

V. Phone/Fax

Practice location:
  • Phone: 336-832-4400
  • Fax: 336-832-4440
Mailing address:
  • Phone: 804-595-1400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2026-00993
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: