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General NPI Number Information
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NPI Number | 1376680306
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Entity Type | Individual
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Provider Name | ANDRYA MITTSU CROSSMAN MD
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Gender | Female
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 08/31/2021
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Provider Practice Location Address
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Address Line | 59 E 54TH ST RM 83
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City | NEW YORK
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State | NY
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Zip | 10022-9206
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Country | US
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Telephone | 646-808-7536
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Fax | 877-512-4792
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Provider Business Mailing Address
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Address Line | 122 E 42ND ST 17TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10168-0002
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Country | US
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Telephone | 646-808-7536
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Fax | 877-512-4792
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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 | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number | 230676
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License Number State | NY
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