Provider Demographics
NPI:1093463614
Name:KRAMER, MALKA
Entity Type:Individual
Prefix:
First Name:MALKA
Middle Name:
Last Name:KRAMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 LAKESIDE DR E
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1718
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:243 NASSAU BLVD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY SOUTH
Practice Address - State:NY
Practice Address - Zip Code:11530-5532
Practice Address - Country:US
Practice Address - Phone:516-387-5143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist