Healthcare Provider Details

I. General information

NPI: 1831789304
Provider Name (Legal Business Name): TESS CRANE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2021
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 DANIEL LN
DIX HILLS NY
11746-5309
US

IV. Provider business mailing address

16 DANIEL LN
DIX HILLS NY
11746-5309
US

V. Phone/Fax

Practice location:
  • Phone: 917-318-7967
  • Fax:
Mailing address:
  • Phone: 917-318-7967
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number090736
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: