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General NPI Number Information
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NPI Number | 1356669097
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Entity Type | Individual
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Provider Name | CORIE LEON CREWS SR. MSW
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Gender | Male
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Dates
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Enumeration Date | 05/05/2010
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Last Update Date | 04/26/2016
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Provider Practice Location Address
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Address Line | 1444 FIFTH AVENUE
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City | BAY SHORE
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State | NY
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Zip | 11706
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Country | US
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Telephone | 631-647-2048
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Fax | 631-647-2057
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Provider Business Mailing Address
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Address Line | PO BOX 753
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City | FARMINGVILLE
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State | NY
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Zip | 11738-0753
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Country | US
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Telephone | 631-364-9560
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Fax | 631-772-4620
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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