Most Relevant Information
Provider Data
| NPI Number: | 1003207994 |
| Provider Name: | CRYSTAL MCGEOWN PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 018407 |
Most Important Dates
| Enumeration Date: | 02/12/2015 |
| Last Updated: | 09/30/2019 |
Provider Practice Location
2119 MERRICK RD
MERRICK
NY
115664704
Practice Location Phone/Fax
| Phone: | 5163772820 |
| Fax: | 5163782968 |
Provider Mailing Location
2119 MERRICK RD
MERRICK
NY
115664704
Provider Mailing Phone/Fax
| Phone: | 5163772820 |
| Fax: | 5163782968 |