Provider Demographics
NPI:1821022971
Name:KRAMER, TERESA DEBARTOLO (ANP C)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:DEBARTOLO
Last Name:KRAMER
Suffix:
Gender:F
Credentials:ANP C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 MT SINAI AVE
Mailing Address - Street 2:
Mailing Address - City:MT SINAI
Mailing Address - State:NY
Mailing Address - Zip Code:11766
Mailing Address - Country:US
Mailing Address - Phone:631-928-0547
Mailing Address - Fax:
Practice Address - Street 1:HSC T17-040
Practice Address - Street 2:NICOLLS ROAD
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794
Practice Address - Country:US
Practice Address - Phone:631-444-1556
Practice Address - Fax:631-444-1618
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF3023361363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health