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General NPI Number Information
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NPI Number | 1093256471
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Entity Type | Individual
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Provider Name | CHARLOTTE JANE CRAWFORD RN
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Gender | Female
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Dates
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Enumeration Date | 03/17/2017
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Last Update Date | 03/17/2017
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Provider Practice Location Address
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Address Line | 575 E MAIN ST
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City | BATAVIA
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State | NY
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Zip | 14020-2741
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Country | US
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Telephone | 585-345-6110
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Fax | 585-345-7452
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Provider Business Mailing Address
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Address Line | 814 SUMNER RD
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City | DARIEN CENTER
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State | NY
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Zip | 14040-9711
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Country | US
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Telephone | 585-409-9117
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Fax | 585-345-7452
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 379224-1
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License Number State | NY
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