1285738575 NPI number — DR. ANGELA A CROWLEY PHD APRN BC PNP

Table of content: DR. ANGELA A CROWLEY PHD APRN BC PNP (NPI 1285738575)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285738575 NPI number — DR. ANGELA A CROWLEY PHD APRN BC PNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CROWLEY
Provider First Name:
ANGELA
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD APRN BC PNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285738575
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 9740
Provider Second Line Business Mailing Address:
100 CHURCH ST SOUTH YALE UNIV SCHOOL OF NURSING
Provider Business Mailing Address City Name:
NEW HAVEN
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06536-0740
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-737-2548
Provider Business Mailing Address Fax Number:
203-785-6455

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20 YORK ST
Provider Second Line Business Practice Location Address:
PCC YALE NEW HAVEN HOSPITAL PEDIATRIC PRIMARY CARE CTR
Provider Business Practice Location Address City Name:
NEW HAVEN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-688-4288
Provider Business Practice Location Address Fax Number:
203-688-5343
Provider Enumeration Date:
09/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  R27369 RN , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 363LP0200X , with the licence number: 000060 APRN , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)





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