Provider Demographics
NPI:1346286861
Name:CRAMER, MARVIN E (MD)
Entity Type:Individual
Prefix:
First Name:MARVIN
Middle Name:E
Last Name:CRAMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 COMMUNITY DR
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5506
Mailing Address - Country:US
Mailing Address - Phone:516-504-0474
Mailing Address - Fax:516-504-0477
Practice Address - Street 1:225 COMMUNITY DR
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5506
Practice Address - Country:US
Practice Address - Phone:516-504-0474
Practice Address - Fax:516-504-0477
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY108705207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB12259Medicare UPIN
NYMC288511Medicare ID - Type Unspecified