Healthcare Provider Details

I. General information

NPI: 1285762401
Provider Name (Legal Business Name): EDWARD R KRAMER JR. DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

174 STATE ROUTE 94
BLAIRSTOWN NJ
07825-2115
US

IV. Provider business mailing address

174 STATE ROUTE 94
BLAIRSTOWN NJ
07825-2115
US

V. Phone/Fax

Practice location:
  • Phone: 908-362-9522
  • Fax: 908-362-8858
Mailing address:
  • Phone: 908-362-9522
  • Fax: 908-362-8858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberMC 1774
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: