Provider Demographics
NPI:1821409376
Name:CRANE, MATTHEW (DO)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:CRANE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVENUE BOX 604 SUITE 6-5436D
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-275-1384
Mailing Address - Fax:585-276-0122
Practice Address - Street 1:601 ELMWOOD AVE STE 6-5436D
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-275-1384
Practice Address - Fax:585-276-0122
Is Sole Proprietor?:No
Enumeration Date:2014-05-17
Last Update Date:2020-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program