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General NPI Number Information
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NPI Number | 1306301106
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Entity Type | Individual
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Provider Name | JASON MARC KRAMAN LSW
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Gender | Male
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Dates
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Enumeration Date | 02/05/2019
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Last Update Date | 02/05/2019
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Provider Practice Location Address
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Address Line | 1021 S 21ST ST STE 2
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City | PHILADELPHIA
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State | PA
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Zip | 19146-2634
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Country | US
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Telephone | 215-790-9943
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Fax |
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Provider Business Mailing Address
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Address Line | 2424 MONTROSE ST
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City | PHILADELPHIA
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State | PA
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Zip | 19146-2427
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Country | US
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Telephone | 610-310-6224
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 134870
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License Number State | PA
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