Healthcare Provider Details

I. General information

NPI: 1144148776
Provider Name (Legal Business Name): ALVIN CRAUSUS RN SUPERVISOR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 ASHBURTON AVE
YONKERS NY
10701-2930
US

IV. Provider business mailing address

65 ASHBURTON AVE
YONKERS NY
10701-2930
US

V. Phone/Fax

Practice location:
  • Phone: 914-963-4000
  • Fax: 914-963-0973
Mailing address:
  • Phone: 914-498-5276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number892558
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: