Provider Demographics
NPI:1871456103
Name:CRAINE, ANTHONY WILLIAM (PTA)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:WILLIAM
Last Name:CRAINE
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 TIFFT RD
Mailing Address - Street 2:
Mailing Address - City:NORTH SMITHFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02896-8009
Mailing Address - Country:US
Mailing Address - Phone:401-440-8090
Mailing Address - Fax:
Practice Address - Street 1:290 BRANCH AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-2713
Practice Address - Country:US
Practice Address - Phone:401-722-8880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-12-04
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI00965225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant