Provider Demographics
NPI:1568682920
Name:CRAPANZANO, CARLY DANA (OD)
Entity Type:Individual
Prefix:DR
First Name:CARLY
Middle Name:DANA
Last Name:CRAPANZANO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8801 SHORE RD
Mailing Address - Street 2:APT. 5H SOUTH
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-5450
Mailing Address - Country:US
Mailing Address - Phone:718-836-2665
Mailing Address - Fax:
Practice Address - Street 1:485 ROUTE 1 S
Practice Address - Street 2:BUILDING A
Practice Address - City:ISELIN
Practice Address - State:NJ
Practice Address - Zip Code:08830-3009
Practice Address - Country:US
Practice Address - Phone:732-750-0400
Practice Address - Fax:732-510-2572
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00604600152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist