Healthcare Provider Details

I. General information

NPI: 1023016300
Provider Name (Legal Business Name): MALCOLM FRANK KRAMER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 10/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

681 RIVER AVE STE 2G
LAKEWOOD NJ
08701-5229
US

IV. Provider business mailing address

681 RIVER AVE STE 2G
LAKEWOOD NJ
08701-5229
US

V. Phone/Fax

Practice location:
  • Phone: 732-364-5522
  • Fax: 732-364-6678
Mailing address:
  • Phone: 732-364-5522
  • Fax: 732-364-6678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberMD000983
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: