TIMOTHY M CRAGG CRNP NPI 1629573332

NPI Information

  • NPI: 1629573332
  • Provider Name: TIMOTHY M CRAGG, CRNP
  • Classification: Nurse Practitioner - 363LG0600X
  • Specialization: Gerontology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3400 SPRUCE ST
    3 RAVDIN
    PHILADELPHIA, PA
    ZIP 19104
  • Phone: (215) 662-3202

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NPI Details

Timothy M Cragg, CRNP is a gerontology nurse practitioner in Philadelphia, PA. Timothy M Cragg, CRNP NPI is 1629573332. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3400 SPRUCE ST
3 RAVDIN
PHILADELPHIA, PA
ZIP 19104-238
Phone: (215) 662-3202

The NPI 1629573332 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 3/26/2018 and was last updated on 3/26/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LG0600XNurse PractitionerGerontologySP018712PENNSYLVANIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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