Healthcare Provider Details

I. General information

NPI: 1235046525
Provider Name (Legal Business Name): MADELYN ROSE KRAMER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WASHINGTON ST
ELMIRA NY
14901-2849
US

IV. Provider business mailing address

18 GROFF RD
HORSEHEADS NY
14845-7926
US

V. Phone/Fax

Practice location:
  • Phone: 607-425-9933
  • Fax:
Mailing address:
  • Phone: 607-425-9933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number670799
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: