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General NPI Number Information
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NPI Number | 1881346062
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Entity Type | Individual
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Provider Name | SAMANTHA A CRANER PA-C, RT(R)
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Gender | Female
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Dates
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Enumeration Date | 01/19/2022
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Last Update Date | 09/10/2023
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Provider Practice Location Address
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Address Line | 1656 CHAMPLIN AVE
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City | UTICA
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State | NY
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Zip | 13502-4830
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Country | US
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Telephone | 315-624-6293
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Fax |
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Provider Business Mailing Address
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Address Line | 1656 CHAMPLIN AVE
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City | UTICA
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State | NY
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Zip | 13502-4830
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Country | US
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Telephone | 315-624-6293
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 863634
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 030134
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License Number State | NY
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