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General NPI Number Information
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NPI Number | 1629202072
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Entity Type | Individual
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Provider Name | GEORGINA MERCEDES CRAMER LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/13/2009
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Last Update Date | 11/26/2013
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Provider Practice Location Address
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Address Line | 299 SYCAMORE LN
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City | ISLANDIA
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State | NY
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Zip | 11749-1586
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Country | US
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Telephone | 631-348-5037
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Fax | 631-348-5163
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Provider Business Mailing Address
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Address Line | 299 SYCAMORE LN
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City | ISLANDIA
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State | NY
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Zip | 11749-1586
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Country | US
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Telephone | 631-348-5037
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Fax | 631-348-5163
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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 | 054430
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 73080412
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License Number State | NY
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