Provider Demographics
NPI:1346659950
Name:CRAMER, IAN MICHAEL (MS, ATC)
Entity Type:Individual
Prefix:
First Name:IAN
Middle Name:MICHAEL
Last Name:CRAMER
Suffix:
Gender:M
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SAXON DR
Mailing Address - Street 2:MCLANE CENTER
Mailing Address - City:ALFRED
Mailing Address - State:NY
Mailing Address - Zip Code:14802-1205
Mailing Address - Country:US
Mailing Address - Phone:607-871-2022
Mailing Address - Fax:607-871-2712
Practice Address - Street 1:1 SAXON DR
Practice Address - Street 2:MCLANE CENTER
Practice Address - City:ALFRED
Practice Address - State:NY
Practice Address - Zip Code:14802-1205
Practice Address - Country:US
Practice Address - Phone:607-871-2022
Practice Address - Fax:607-871-2712
Is Sole Proprietor?:No
Enumeration Date:2014-08-07
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002702-12255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer