Healthcare Provider Details

I. General information

NPI: 1376530105
Provider Name (Legal Business Name): JANE D KRAFT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 09/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 E MAIN ST
SPRINGVILLE NY
14141-1229
US

IV. Provider business mailing address

21 E MAIN ST
SPRINGVILLE NY
14141-1229
US

V. Phone/Fax

Practice location:
  • Phone: 716-592-8931
  • Fax: 716-592-2152
Mailing address:
  • Phone: 716-592-8931
  • Fax: 716-592-2152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number187358
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: