Individual provider Active NPI

Jennifer Crosby

  • Behavior Analyst
  • Holbrook, NY
National Provider Identifier
1891264057
Registry record updated Nov 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
991 Main St Ste 100
Holbrook, NY 11741-1608
Phone
(631) 676-5645
NPI assigned
Nov 16, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

991 Main St Ste 100
Holbrook, NY 11741-1608

Mailing address

152 E Lakewood St
Patchogue, NY 11772-2943

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1542326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542326400000",
    "number": "1891264057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 E LAKEWOOD ST",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117722943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "991 MAIN ST STE 100",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117411608",
            "telephone_number": "631-676-5645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSBY",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-16",
        "last_updated": "2018-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holbrook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2018; 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.