Individual provider · Type 1 NPI
Tyrone Craddock
Private Vehicle · Bridgeport, CT
NPI number
1205472396
Active
Practice location
47 Woodlawn Ave
Bridgeport, CT 06606-2962
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Driver | 172A00000X | 347C00000X (FL) |
| Private Vehicle Primary | 347C00000X | 347C00000X (CT) |
Private Vehicle: An individual paid to provide non-emergency transportation using their privately owned/leased vehicle.
Another provider at this address
About NPI 1205472396
Tyrone Craddock's National Provider Identifier is 1205472396, issued on Nov 23, 2019. The primary taxonomy on file is Private Vehicle (347C00000X), and the practice location is in Bridgeport, CT. The record was last updated on Nov 23, 2019.