Provider Demographics
NPI:1073613998
Name:CRANE, STEPHEN (MD)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:
Last Name:CRANE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 MOUNT PLEASANT AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-2724
Mailing Address - Country:US
Mailing Address - Phone:973-731-7707
Mailing Address - Fax:973-669-0277
Practice Address - Street 1:375 MOUNT PLEASANT AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-2724
Practice Address - Country:US
Practice Address - Phone:973-731-7707
Practice Address - Fax:973-669-0277
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05030300207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E56812Medicare UPIN
CR626834Medicare ID - Type Unspecified