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NPI Code Detail

MEDICARE: LAUREN CROWL PA

MEDICARE:   LAUREN  CROWL  PA
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
1363A00000XPhysician Assistant007317NY

General Provider Information

NPI Number : 1205835584
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN CROWL PA
Provider Business Mailing Address
First Line : PO BOX 769
Second Line :
City : KEENE VALLEY
State : NY
Zip : 12943-0769
Country : US
Telephone Number : 518-523-1327
Fax Number :
Provider Business Practice Location Address
First Line : 29 CHURCH ST
Second Line :
City : LAKE PLACID
State : NY
Zip : 12946-1805
Country : US
Telephone Number : 518-523-1327
Fax Number : 518-523-9964
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2005
Last Update Date : 06/16/2008

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Directions to “ LAUREN CROWL PA” Practice Location

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