Healthcare Provider Details

I. General information

NPI: 1750463782
Provider Name (Legal Business Name): MARC B KRAMER PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 11/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 E 89TH ST
NEW YORK NY
10128-2305
US

IV. Provider business mailing address

160 E 89TH ST
NEW YORK NY
10128-2305
US

V. Phone/Fax

Practice location:
  • Phone: 212-722-8600
  • Fax: 212-828-9570
Mailing address:
  • Phone: 212-722-8600
  • Fax: 212-828-9570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number10
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAT000514L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: