Provider Demographics
NPI:1447494604
Name:CROWLEY, STACEY ANN (NP)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:ANN
Last Name:CROWLEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:STACEY
Other - Middle Name:ANN
Other - Last Name:WALKER CROWLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:2 OVERHILL ROAD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583
Mailing Address - Country:US
Mailing Address - Phone:914-722-9440
Mailing Address - Fax:914-722-9441
Practice Address - Street 1:2 OVERHILL ROAD
Practice Address - Street 2:SUITE 260
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583
Practice Address - Country:US
Practice Address - Phone:914-722-9440
Practice Address - Fax:914-722-9441
Is Sole Proprietor?:No
Enumeration Date:2009-04-30
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17565363LF0000X
NYF342479363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily