Provider Demographics
NPI:1023016300
Name:KRAMER, MALCOLM FRANK (DPM)
Entity Type:Individual
Prefix:DR
First Name:MALCOLM
Middle Name:FRANK
Last Name:KRAMER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:681 RIVER AVE
Mailing Address - Street 2:STE 2G
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5229
Mailing Address - Country:US
Mailing Address - Phone:732-364-5522
Mailing Address - Fax:732-364-6678
Practice Address - Street 1:681 RIVER AVE
Practice Address - Street 2:STE 2G
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5229
Practice Address - Country:US
Practice Address - Phone:732-364-5522
Practice Address - Fax:732-364-6678
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-12
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD000983213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJKR441301Medicare PIN
T73136Medicare UPIN