MEDICARE: NADINE ANTOINETTE CROSDALE

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	14890	CT
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	407244	NY
3	163WM0102X	Maternal Newborn Registered Nurse	10.164358	CT
4	163WS0200X	School Registered Nurse	699581	NY

General Provider Information

NPI Number	:	1952293748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NADINE ANTOINETTE CROSDALE

Provider Business Mailing Address
First Line	:	5951 RIVERDALE AVE UNIT 185
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10471-4307
Country	:	US
Telephone Number	:	347-327-7244
Fax Number	:

Provider Business Practice Location Address
First Line	:	5951 RIVERDALE AVE UNIT 185
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10471-4307
Country	:	US
Telephone Number	:	347-327-7244
Fax Number	:

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

Provider Enumeration Date	:	07/17/2025
Last Update Date	:	10/10/2025

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