MEDICARE: SARAH BLUMENGARTEN CRAWFORD PSY.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	103TC2200X	Clinical Child & Adolescent Psychologist

General Provider Information

NPI Number	:	1467614669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH BLUMENGARTEN CRAWFORD PSY.D.

Provider Business Mailing Address
First Line	:	2400 TAMARACK AVE
Second Line	:	STE 201
City	:	SOUTH WINDSOR
State	:	CT
Zip	:	06074-5559
Country	:	US
Telephone Number	:	860-432-1199
Fax Number	:	860-432-1152

Provider Business Practice Location Address
First Line	:	2400 TAMARACK AVE
Second Line	:	STE 201
City	:	SOUTH WINDSOR
State	:	CT
Zip	:	06074-5559
Country	:	US
Telephone Number	:	860-432-1199
Fax Number	:

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

Provider Enumeration Date	:	06/28/2008
Last Update Date	:	03/15/2016

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