Provider Demographics
NPI:1013480730
Name:CRAFT, DANA D (MS ED)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:D
Last Name:CRAFT
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 983
Mailing Address - Street 2:
Mailing Address - City:MONTAUK
Mailing Address - State:NY
Mailing Address - Zip Code:11954-0801
Mailing Address - Country:US
Mailing Address - Phone:631-668-6244
Mailing Address - Fax:
Practice Address - Street 1:179 ESSEX ST
Practice Address - Street 2:
Practice Address - City:MONTAUK
Practice Address - State:NY
Practice Address - Zip Code:11954-5406
Practice Address - Country:US
Practice Address - Phone:631-268-4809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-04
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency