Provider Demographics
NPI:1144865221
Name:CRANIO ASSOCIATES PA
Entity type:Organization
Organization Name:CRANIO ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:FEDERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:201-592-7727
Mailing Address - Street 1:PO BOX 825
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07015-0825
Mailing Address - Country:US
Mailing Address - Phone:973-772-2200
Mailing Address - Fax:973-772-4900
Practice Address - Street 1:2185 LE MOINE AVENUE
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-6319
Practice Address - Country:US
Practice Address - Phone:201-592-7727
Practice Address - Fax:201-592-0971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty