Provider Demographics
NPI:1003083189
Name:ROGER D. KRAMER, PH.D., P.C.
Entity Type:Organization
Organization Name:ROGER D. KRAMER, PH.D., P.C.
Other - Org Name:PSYQI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:D
Authorized Official - Last Name:KRAMER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:516-848-8884
Mailing Address - Street 1:PO BOX 1143
Mailing Address - Street 2:
Mailing Address - City:SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-0813
Mailing Address - Country:US
Mailing Address - Phone:516-848-8884
Mailing Address - Fax:
Practice Address - Street 1:286 SILLS RD
Practice Address - Street 2:
Practice Address - City:EAST PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-8810
Practice Address - Country:US
Practice Address - Phone:516-848-8884
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty