Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC1500X | Nurse Practitioner - Community Health | 320069F | NY |
Y | 363LC1500X | Nurse Practitioner - Community Health | F320069 | NY |
NPI | 1033448840 |
---|---|
Provider Name | Mr. Richard Anthony Crookson |
First Address | New York, NY 10010-1600 |
Second Address | Brooklyn, NY 11225 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2009 |
Last Update Date | 05/03/2019 |