Madera, Crystal
Madera, Crystal is an sole proprietor health care provider with primary practice located at 8527 58Th Ave Apt 2 , Elmhurst NY 11373-4811. She recently has only one registered license in Agencies / Early Intervention Provider Agency, which is considered as her primary health care specialty. Madera, Crystal can be contacted via phone (347) 846-8326.Contact Information
Primary practice address
8527 58Th Ave Apt 2
Elmhurst NY 11373-4811
Phone: (347) 846-8326
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Agencies / Early Intervention Provider Agency | 252Y00000X |
Profile Details
| NPI number | 1386142370 |
|---|---|
| LBN Legal business name | Madera, Crystal |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 25th, 2018 |
| Last updated | Jan 25th, 2018 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386142370 | NPPES |
| New York | MEDICAID | JLJ003837567 |
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