Provider Demographics
NPI:1356896625
Name:CRAMER, KORIE ALECXIH (PA-C)
Entity type:Individual
Prefix:
First Name:KORIE
Middle Name:ALECXIH
Last Name:CRAMER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KORIE
Other - Middle Name:BRIANNE
Other - Last Name:ALECXIH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3400 SPRUCE ST
Mailing Address - Street 2:9 FOUNDERS
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4238
Mailing Address - Country:US
Mailing Address - Phone:215-662-7355
Mailing Address - Fax:215-349-8444
Practice Address - Street 1:3400 SPRUCE ST
Practice Address - Street 2:9 FOUNDERS
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-662-7355
Practice Address - Fax:215-349-8444
Is Sole Proprietor?:No
Enumeration Date:2016-08-16
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA059084363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical