Provider Demographics
NPI:1972627883
Name:PHILIP KRAMER
Entity Type:Organization
Organization Name:PHILIP KRAMER
Other - Org Name:LYNN ORTHOPEDIC BRATTLEBORO ORTHOTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAMER
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:802-254-1141
Mailing Address - Street 1:PO BOX 8344
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05304-8344
Mailing Address - Country:US
Mailing Address - Phone:802-254-1141
Mailing Address - Fax:802-254-3494
Practice Address - Street 1:276 CANAL ST
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-6464
Practice Address - Country:US
Practice Address - Phone:802-254-1141
Practice Address - Fax:802-254-3494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-17
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT19778OtherBLUE CROSS
VT1004632Medicaid
VT19778OtherBLUE CROSS