Provider Demographics
NPI:1760552509
Name:CRAINE, KARINA (MD)
Entity Type:Individual
Prefix:
First Name:KARINA
Middle Name:
Last Name:CRAINE
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 1:31 STONE CREST DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-2632
Mailing Address - Country:US
Mailing Address - Phone:845-325-8732
Mailing Address - Fax:
Practice Address - Street 1:CORNER OF ROUTE N7 AND N1
Practice Address - Street 2:FORT DEFIANCE INDIAN HOSPITAL
Practice Address - City:FORT DEFIANCE
Practice Address - State:AZ
Practice Address - Zip Code:86504
Practice Address - Country:US
Practice Address - Phone:928-729-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY240064208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics