Healthcare Provider Details

I. General information

NPI: 1801243555
Provider Name (Legal Business Name): COREY CRAMER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2016
Last Update Date: 06/14/2024
Certification Date: 06/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 N BROADWAY
PENNSVILLE NJ
08070-1550
US

IV. Provider business mailing address

134 BRIDGETON PIKE STE C
MULLICA HILL NJ
08062-2616
US

V. Phone/Fax

Practice location:
  • Phone: 856-678-9002
  • Fax: 856-678-4027
Mailing address:
  • Phone: 856-507-2783
  • Fax: 856-221-4138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MA12232900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMT210760
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: