| Melissa C. Crookshank Md Llc | |
|
829 Spruce St Suite 302 Philadelphia PA 19107-5752 | |
| (215) 829-5611 | |
| Not Available |
| Full Name | Melissa C. Crookshank Md Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 829 Spruce St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Melissa Catherine Crookshank (OWNER) |
| Authorized Official Contact | 2158295611 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Melissa C. Crookshank Md Llc 646 Lincoln Hwy Suite 7 Fairless Hills PA 19030-1410 Ph: (215) 295-1717 | Melissa C. Crookshank Md Llc 829 Spruce St Suite 302 Philadelphia PA 19107-5752 Ph: (215) 829-5611 |
| NPI Number | 1700193307 |
|---|---|
| Provider Enumeration Date | 09/03/2010 |
| Last Update Date | 09/03/2010 |
| Medicare PECOS PAC ID | 4183812340 |
|---|---|
| Medicare Enrollment ID | O20110103000912 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700193307 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | MD437211 (Pennsylvania) | Primary |
| Provider Name | Melissa Catherine Crookshank |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558522490 PECOS PAC ID: 5092903252 Enrollment ID: I20110103000940 |
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