Provider Demographics
NPI:1497702963
Name:CRANMER, ANNA H (MD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:H
Last Name:CRANMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 ADELINE PL
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD CENTER
Mailing Address - State:CT
Mailing Address - Zip Code:06250-1656
Mailing Address - Country:US
Mailing Address - Phone:860-456-8650
Mailing Address - Fax:
Practice Address - Street 1:112 MANSFIELD AVE
Practice Address - Street 2:WINDHAM HOSPITAL
Practice Address - City:WILLIAMANTIC
Practice Address - State:CT
Practice Address - Zip Code:06226
Practice Address - Country:US
Practice Address - Phone:860-456-9116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-28
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA74527207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8895406Medicaid
CTP00796117Medicare PIN
H25941Medicare UPIN
NJ8895406Medicaid
CT930001553Medicare PIN