MEDICARE: ROGER D. KRAMER, PH.D., P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist

General Provider Information

NPI Number	:	1003083189
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROGER D. KRAMER, PH.D., P.C.

Provider Business Mailing Address
First Line	:	PO BOX 1143
Second Line	:
City	:	SETAUKET
State	:	NY
Zip	:	11733-0813
Country	:	US
Telephone Number	:	516-848-8884
Fax Number	:

Provider Business Practice Location Address
First Line	:	286 SILLS RD
Second Line	:
City	:	EAST PATCHOGUE
State	:	NY
Zip	:	11772-8810
Country	:	US
Telephone Number	:	516-848-8884
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROGER D KRAMER
Credential	:	PH.D.
Telephone Number	:	516-848-8884

Provider Enumeration Date	:	05/08/2008
Last Update Date	:	05/08/2008

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