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NPI Code Detail

MEDICARE: ANTOINE CRAIG

MEDICARE:   ANTOINE  CRAIG
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
1376K00000XNurse's Aide

General Provider Information

NPI Number : 1144828278
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTOINE CRAIG
Provider Business Mailing Address
First Line : PO BOX 362
Second Line :
City : SOUTHAMPTON
State : NY
Zip : 11969-0362
Country : US
Telephone Number : 631-506-9257
Fax Number :
Provider Business Practice Location Address
First Line : 33 LINCOLN RD
Second Line :
City : PATCHOGUE
State : NY
Zip : 11772-1728
Country : US
Telephone Number : 631-506-9257
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2020
Last Update Date : 10/12/2020

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Directions to “ ANTOINE CRAIG ” Practice Location

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