MEDICARE: HEATHER LORRAINE CROWLEY M.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	207ZC0500X	Cytopathology Physician	11901	NH
2	207ZC0500X	Cytopathology Physician	209819	MA
3	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	209819	MA
4	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	11901	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336142595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER LORRAINE CROWLEY M.D.

Provider Business Mailing Address
First Line	:	1 ELLIOT WAY
Second Line	:
City	:	MANCHESTER
State	:	NH
Zip	:	03103-3502
Country	:	US
Telephone Number	:	603-663-2583
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 ELLIOT WAY
Second Line	:
City	:	MANCHESTER
State	:	NH
Zip	:	03103-3502
Country	:	US
Telephone Number	:	603-663-2583
Fax Number	:

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	08/26/2024

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Directions to “ HEATHER LORRAINE CROWLEY M.D.” Practice Location

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