Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 152W00000X | Optometrist | 5083 | MA |
Y | 152W00000X | Optometrist | OEG002936 | PA |
NPI | 1003220880 |
---|---|
Provider Name | Dr. Abby Brubaker Crawford |
First Address | Vienna, VA 22182-3970 |
Second Address | Lancaster, PA 17603-4359 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2014 |
Last Update Date | 21/10/2021 |