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General NPI Number Information
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NPI Number | 1184033367
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Entity Type | Individual
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Provider Name | JENNIFER M CROUSE
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Gender | Female
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Dates
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Enumeration Date | 08/12/2014
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Last Update Date | 08/06/2019
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Provider Practice Location Address
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Address Line | 549 ROWLAND STREET EXT
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-6156
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Country | US
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Telephone | 518-332-8487
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Fax |
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Provider Business Mailing Address
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Address Line | 549 ROWLAND STREET EXT
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-6156
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Country | US
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Telephone | 518-332-8487
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Fax |
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 037909
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 037909
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License Number State | NY
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