Healthcare Provider Details

I. General information

NPI: 1447213863
Provider Name (Legal Business Name): HEATHER CRAWFORD D.P.M
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 E MAIN ST UNIT 4D
LITTLE EGG HARBOR TWP NJ
08087-2669
US

IV. Provider business mailing address

125 E MAIN ST UNIT 4D
LITTLE EGG HARBOR NJ
08087-2669
US

V. Phone/Fax

Practice location:
  • Phone: 609-296-3533
  • Fax: 609-296-4742
Mailing address:
  • Phone: 609-296-3533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number25MD00248400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: