Provider Demographics
NPI:1205023082
Name:CRANE, CATHY A (DC)
Entity Type:Individual
Prefix:DR
First Name:CATHY
Middle Name:A
Last Name:CRANE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 ALDERMAN RD
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:NY
Mailing Address - Zip Code:14522-9555
Mailing Address - Country:US
Mailing Address - Phone:315-597-3888
Mailing Address - Fax:
Practice Address - Street 1:1211 ALDERMAN RD
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:NY
Practice Address - Zip Code:14522-9555
Practice Address - Country:US
Practice Address - Phone:315-597-3888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-26
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYXOO8888-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBB8309Medicare PIN