Healthcare Provider Details

I. General information

NPI: 1124296066
Provider Name (Legal Business Name): MALCOLM F. KRAMER,DPM,PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2008
Last Update Date: 03/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

681 RIVER AVE
LAKEWOOD NJ
08701-5229
US

IV. Provider business mailing address

681 RIVER AVE
LAKEWOOD NJ
08701-5229
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number25MD00098300
License Number StateNJ

VIII. Authorized Official

Name: DR. MALCOLM FRANK KRAMER
Title or Position: PODIATRY
Credential: DPM
Phone: 732-364-5522