Provider Demographics
NPI:1669088878
Name:CRANE, DAREN (MS, ATC)
Entity type:Individual
Prefix:
First Name:DAREN
Middle Name:
Last Name:CRANE
Suffix:
Gender:M
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 AYRSHIRE LN
Mailing Address - Street 2:
Mailing Address - City:HENRIETTA
Mailing Address - State:NY
Mailing Address - Zip Code:14467-9378
Mailing Address - Country:US
Mailing Address - Phone:585-259-7108
Mailing Address - Fax:
Practice Address - Street 1:1799 LEHIGH STATION ROAD
Practice Address - Street 2:
Practice Address - City:HENRIETTA
Practice Address - State:NY
Practice Address - Zip Code:14467
Practice Address - Country:US
Practice Address - Phone:585-359-5295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000313-012255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer