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General NPI Number Information
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NPI Number | 1104811645
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Entity Type | Individual
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Provider Name | LILLIAN VIRGINIA KRAMAN-ROACH MD
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Gender | Female
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Dates
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Enumeration Date | 09/12/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 846 WALKER RD SUITE 31-2
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City | DOVER
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State | DE
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Zip | 19904-2756
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Country | US
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Telephone | 302-674-9188
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Fax | 302-674-1108
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Provider Business Mailing Address
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Address Line | PO BOX 589
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City | CAMDEN WYOMING
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State | DE
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Zip | 19934-0589
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Country | US
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Telephone | 302-674-9188
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Fax | 302-674-1108
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | C10004688
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License Number State | DE
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