Provider Demographics
NPI:1588669949
Name:KEIB CRAMER, CAROLINE W (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:W
Last Name:KEIB CRAMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CAROLINE
Other - Middle Name:W
Other - Last Name:KEIB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1001 W FAYETTE ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13204-2859
Mailing Address - Country:US
Mailing Address - Phone:315-479-5070
Mailing Address - Fax:315-701-2525
Practice Address - Street 1:739 IRVING AVE
Practice Address - Street 2:STE 200
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1668
Practice Address - Country:US
Practice Address - Phone:315-479-5070
Practice Address - Fax:315-701-2525
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205847207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01856931Medicaid
NYBB0587Medicare ID - Type Unspecified
J400027512Medicare PIN
NY01856931Medicaid
NYG68402Medicare UPIN