Provider Demographics
NPI:1043517378
Name:KRAMER, SAMANTHA EMILY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:EMILY
Last Name:KRAMER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5619 MOSHOLU AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-2410
Mailing Address - Country:US
Mailing Address - Phone:516-521-0496
Mailing Address - Fax:
Practice Address - Street 1:5619 MOSHOLU AVE FL 2
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10471-2410
Practice Address - Country:US
Practice Address - Phone:516-521-0496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-23
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024816103TC0700X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health