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NPI Code Detail

MEDICARE: MARLENE E KRAMER JR. PTA

MEDICARE: MARLENE E KRAMER JR. PTA
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
1225200000XPhysical Therapy Assistant015117NY

General Provider Information

NPI Number : 1194655886
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARLENE E KRAMER JR. PTA
Provider Business Mailing Address
First Line : 329 E PENN ST
Second Line :
City : LONG BEACH
State : NY
Zip : 11561-4331
Country : US
Telephone Number : 516-589-5481
Fax Number :
Provider Business Practice Location Address
First Line : 300 DOUGLAS ST
Second Line :
City : PETALUMA
State : CA
Zip : 94952-2503
Country : US
Telephone Number : 707-763-6887
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2026
Last Update Date : 05/22/2026

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