1912980509 NPI number — FAITH KRAMER RN,CF

Table of content: FAITH KRAMER RN,CF (NPI 1912980509)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912980509 NPI number — FAITH KRAMER RN,CF

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KRAMER
Provider First Name:
FAITH
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN,CF
Provider Gender Code:
F

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:
1912980509
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/26/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21 CANTERBURY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARBLEHEAD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01945-1003
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-639-0049
Provider Business Mailing Address Fax Number:
781-631-7053

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
79 HIGHLAND AVE
Provider Second Line Business Practice Location Address:
SUITE 216
Provider Business Practice Location Address City Name:
SALEM
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01970-2711
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-592-7457
Provider Business Practice Location Address Fax Number:
781-631-7053
Provider Enumeration Date:
11/28/2005

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: 332B00000X , with the licence number:  D/N/A , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 222Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 601336 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1534009 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 336454 . This is a "BLUE CROSS OF MASS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 703042 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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