Individual provider Active NPI

Suzanne Sophia Crane, PT

  • Pediatric Physical Therapist
  • Middle Village, NY
National Provider Identifier
1548415540
Registry record updated Nov 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
017666-1 Issued in NY
Practice address
6325 Dry Harbor Rd
Middle Village, NY 11379-1964
Phone
(718) 639-9750
NPI assigned
Nov 18, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 017666-1 NY Primary

Addresses

Primary practice location

6325 Dry Harbor Rd
Middle Village, NY 11379-1964

Mailing address

985 Benton St
Woodmere, NY 11598-1706
Phone (516) 374-6299

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

LicenseStateTypeSpecialty
017666-1NYMDPediatric Physical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1226966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226966400000",
    "number": "1548415540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "985 BENTON ST",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981706",
            "telephone_number": "516-374-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6325 DRY HARBOR RD",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "113791964",
            "telephone_number": "718-639-9750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANE",
        "first_name": "SUZANNE",
        "middle_name": "SOPHIA",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-18",
        "last_updated": "2008-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NY",
            "license": "017666-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middle Village, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.