Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | P380758 | NY |
NPI | 1023003894 |
---|---|
Provider Name | Elizabeth Mary Cramer |
First Address | East Hampton, NY 11937-5921 |
Second Address | East Hampton, NY 11937-5921 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2005 |
Last Update Date | 02/03/2011 |