MEDICARE: MR. JASON MARC KRAMAN LSW

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	104100000X	Social Worker	134870	PA

General Provider Information

NPI Number	:	1306301106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JASON MARC KRAMAN LSW

Provider Business Mailing Address
First Line	:	2424 MONTROSE ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-2427
Country	:	US
Telephone Number	:	610-310-6224
Fax Number	:

Provider Business Practice Location Address
First Line	:	1021 S 21ST ST STE 2
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-2634
Country	:	US
Telephone Number	:	215-790-9943
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2019
Last Update Date	:	02/05/2019

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