Healthcare Provider Details

I. General information

NPI: 1316768021
Provider Name (Legal Business Name): JAMES P CROUSE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2024
Last Update Date: 10/24/2024
Certification Date: 10/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

162 BROAD ST
FLEMINGTON NJ
08822-1603
US

IV. Provider business mailing address

1075 STEPHENSON AVE UNIT C
OCEANPORT NJ
07757-1242
US

V. Phone/Fax

Practice location:
  • Phone: 908-788-5979
  • Fax:
Mailing address:
  • Phone: 848-208-2636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: