MEDICARE: DAVID S. CROWLEY O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	27OA00457400	NJ

General Provider Information

NPI Number	:	1033356084
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID S. CROWLEY O.D.

Provider Business Mailing Address
First Line	:	4620 BLACK HORSE PIKE
Second Line	:
City	:	MAYS LANDING
State	:	NJ
Zip	:	08330-3213
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4620 BLACK HORSE PIKE
Second Line	:
City	:	MAYS LANDING
State	:	NJ
Zip	:	08330-3213
Country	:	US
Telephone Number	:	609-625-7301
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2009
Last Update Date	:	01/13/2009

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