MEDICARE: DR. THEODORE IAN KRAMER M.D.

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	207R00000X	Internal Medicine Physician	MA057347	NJ

General Provider Information

NPI Number	:	1730334988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THEODORE IAN KRAMER M.D.

Provider Business Mailing Address
First Line	:	73 WHITNEY RD
Second Line	:
City	:	SHORT HILLS
State	:	NJ
Zip	:	07078-3420
Country	:	US
Telephone Number	:	973-493-4124
Fax Number	:

Provider Business Practice Location Address
First Line	:	73 WHITNEY RD
Second Line	:
City	:	SHORT HILLS
State	:	NJ
Zip	:	07078-3420
Country	:	US
Telephone Number	:	973-493-4124
Fax Number	:

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

Provider Enumeration Date	:	12/01/2008
Last Update Date	:	12/01/2008

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