Crocenzi, Todd Shane
Crocenzi, Todd Shane is an individual health care provider with primary practice located at 4805 Ne Glisan St 6N40, Portland OR 97213-2933. He recently has only one registered license in Allopathic & Osteopathic Physicians / Medical Oncology, which is considered as his primary health care specialty. Crocenzi, Todd Shane can be contacted via phone (503) 215-5696.Contact Information
Primary practice address
4805 Ne Glisan St 6N40
Portland OR 97213-2933
Phone: (503) 215-5696
Fax: (503) 215-5695
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Medical Oncology | 207RX0202X | MD26231 | Oregon |
Profile Details
| NPI number | 1336130806 |
|---|---|
| LBN Legal business name | Crocenzi, Todd Shane |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 2nd, 2005 |
| Last updated | Oct 29th, 2008 - about 18 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 | 1336130806 | NPPES |
| Oregon | MEDICAID | 027918 |
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