Provider Demographics
NPI:1689135105
Name:KRAMER, MARYJO (MD)
Entity Type:Individual
Prefix:
First Name:MARYJO
Middle Name:
Last Name:KRAMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 35TH ST NW APT 5
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-2351
Mailing Address - Country:US
Mailing Address - Phone:516-996-4575
Mailing Address - Fax:
Practice Address - Street 1:375 BOYLSTON ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-6007
Practice Address - Country:US
Practice Address - Phone:617-525-9542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-27
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program