=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750489423
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DR. LAWRENCE D KRAMER
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/20/2006
-----------------------------------------------------
Last Update Date | 09/23/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4215 3RD AVE 2ND FLOOR
-----------------------------------------------------
City | BRONX
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10457-4501
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-294-5891
-----------------------------------------------------
Fax | 718-294-2468
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 60 MADISON AVE 5TH FLOOR
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10010-1600
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-545-2439
-----------------------------------------------------
Fax | 646-312-0481
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 135138
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------