Provider Demographics
NPI:1205900347
Name:JANE D. KRAFT, MD, PLLC
Entity type:Organization
Organization Name:JANE D. KRAFT, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:D
Authorized Official - Last Name:KRAFT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-592-8931
Mailing Address - Street 1:21 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14141-1229
Mailing Address - Country:US
Mailing Address - Phone:716-592-8931
Mailing Address - Fax:716-592-2152
Practice Address - Street 1:21 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRINGVILLE
Practice Address - State:NY
Practice Address - Zip Code:14141-1229
Practice Address - Country:US
Practice Address - Phone:716-592-8931
Practice Address - Fax:716-592-2152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2014-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY187358207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYDD7835OtherRAILROAD MEDICARE
NYDD7835OtherRAILROAD MEDICARE