1659360923 NPI number — DEBRA A KRAMER CRNP

Table of content: DEBRA A KRAMER CRNP (NPI 1659360923)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659360923 NPI number — DEBRA A KRAMER CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KRAMER
Provider First Name:
DEBRA
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BISHWATY
Provider Other First Name:
DEBRA
Provider Other Middle Name:
A
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CRNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1659360923
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1320 BROADCASTING RD
Provider Second Line Business Mailing Address:
STE 200
Provider Business Mailing Address City Name:
READING
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19610-3222
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-372-8995
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5018 MEDICAL CENTER CIR
Provider Second Line Business Practice Location Address:
SUITE 240
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18106-9661
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-876-5649
Provider Business Practice Location Address Fax Number:
610-437-4320
Provider Enumeration Date:
10/19/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  VP001992C , 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: 50032693 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 103246301 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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