Provider Demographics
NPI:1083668164
Name:BELLMORE MEDICAL ASSOCIATES PC
Entity Type:Organization
Organization Name:BELLMORE MEDICAL ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-785-6677
Mailing Address - Street 1:2631 MERRICK RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-5784
Mailing Address - Country:US
Mailing Address - Phone:516-785-6677
Mailing Address - Fax:516-785-6912
Practice Address - Street 1:2631 MERRICK RD
Practice Address - Street 2:SUITE 101
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-5784
Practice Address - Country:US
Practice Address - Phone:516-785-6677
Practice Address - Fax:516-785-6912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY096896207Q00000X
NY236616207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty