Healthcare Provider Details

I. General information

NPI: 1821865205
Provider Name (Legal Business Name): JOSHUA CROWDING
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2023
Last Update Date: 06/21/2025
Certification Date: 06/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

158 E WOLFERT STATION RD
MICKLETON NJ
08056-1432
US

IV. Provider business mailing address

158 E WOLFERT STATION RD
MICKLETON NJ
08056-1432
US

V. Phone/Fax

Practice location:
  • Phone: 856-535-1993
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number25MT00342200
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: