Healthcare Provider Details

I. General information

NPI: 1205723152
Provider Name (Legal Business Name): ANNA KRAMER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2025
Last Update Date: 08/06/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 BOYLSTON ST
CHESTNUT HILL MA
02467-2477
US

IV. Provider business mailing address

49 WALTHAM ST UNIT 2
MAYNARD MA
01754-2456
US

V. Phone/Fax

Practice location:
  • Phone: 978-857-4396
  • Fax:
Mailing address:
  • Phone: 978-857-4396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA101869
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: