MEDICARE: HELEN KRAMER OTR/L

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	171W00000X	Contractor	04915-01	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	04915-01	OTHER	NY	NEW YORK STATE LISENCE

General Provider Information

NPI Number	:	1639472640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HELEN KRAMER OTR/L

Provider Business Mailing Address
First Line	:	75 MARSHALL DR
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08817-2910
Country	:	US
Telephone Number	:	732-339-9077
Fax Number	:

Provider Business Practice Location Address
First Line	:	75 MARSHALL DR
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08817-2910
Country	:	US
Telephone Number	:	732-339-9077
Fax Number	:

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

Provider Enumeration Date	:	12/13/2010
Last Update Date	:	12/13/2010

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