1770707762 NPI number — RONALD P. CRAMER,D.O.,P.C.

Table of content: (NPI 1770707762)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770707762 NPI number — RONALD P. CRAMER,D.O.,P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RONALD P. CRAMER,D.O.,P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1770707762
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
661 ORCHARD TERRACE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW WILMINGTON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16142-4217
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-946-9705
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
713 WOOD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLARION
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16214-1533
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-227-2343
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CRAMER
Authorized Official First Name:
RONALD
Authorized Official Middle Name:
P.
Authorized Official Title or Position:
COMM. REGISTERED OFFICE PROVIDER
Authorized Official Telephone Number:
814-227-2343

Provider Taxonomy Codes

  • Taxonomy code: 207RG0100X , with the licence number:  05007823L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1982532 . This is a "BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2615411 . This is a "AETNAHMO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 05007823L . This is a "LICENSE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 341721 . This is a "HEALTH AMERICA/ASSURANCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 5164651 . This is a "AETNANONHMO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 054806 . This is a "SELECT BLUE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1020347620001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: DG3389 . This is a "MEDICARE TRAVELERS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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