Active NPI
Laura Ann Crandall, PT
- Physical Therapist
- Montclair, NJ
National Provider Identifier
1023444817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 011674-1
- Practice address
- 267 Park St
Montclair, NJ 07043-1732 - Phone
- (973) 744-8205
- NPI assigned
- Sep 24, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 011674-1 | NY | Primary |
| Physical Therapist | 225100000X | 4OQA00734900 | NJ |
Addresses
Primary practice location
267 Park St
Montclair, NJ 07043-1732
Mailing address
267 Park St
Montclair, NJ 07043-1732
Phone (973) 744-8205
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4OQA00734900 | NJ | MD | Physical Therapist |
| 011674-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379980800000",
"number": "1023444817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "267 PARK ST",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070431732",
"telephone_number": "973-744-8205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "267 PARK ST",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070431732",
"telephone_number": "973-744-8205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRANDALL",
"first_name": "LAURA",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-24",
"last_updated": "2013-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "011674-1",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "4OQA00734900",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montclair, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.