Crown of Life Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

1180L001 Issued in NY

Legal business name

CROWN OF LIFE INC

Practice address

14644 Lakewood Ave
Jamaica, NY 11435-5438

Phone

(718) 526-8921

NPI assigned

Jan 29, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Randy Anglin

Title

Sole Proprietor

Phone

(718) 526-8921

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629114723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14644 LAKEWOOD AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114355438",
            "telephone_number": "718-526-8921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14644 LAKEWOOD AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114355438",
            "telephone_number": "718-526-8921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROWN OF LIFE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANGLIN",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "718-526-8921"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "1180L001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02177580",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02335106",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02431905",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02433654",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miscilla Criam
• Shannon S Crichlow
• Shantay N Crichlow
• Cross County Chiropractic, P.C.
• Bindy Crouch
• Vanessa Maria Cruz, OTR/L
• Crystal Adult Social Day Care LLC
• Crystal Health Care Nurse Practitioner in Family Health P.C.
• Crystal's Optics Inc
• Chris Gerard Baun Cueto, D.C.

• Specialist in Jamaica, NY
• Providers in Jamaica, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.