Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | MD000983 | NJ |
Y | 222Z00000X | Podiatrist | MD000983 | NJ |
NPI | 1023016300 |
---|---|
Provider Name | Dr. Malcolm Frank Kramer |
First Address | Lakewood, NJ 08701-5229 |
Second Address | Lakewood, NJ 08701-5229 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2005 |
Last Update Date | 29/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T73136 | (02) |