Provider Demographics
NPI:1770590499
Name:KRAMER, ROBERT J (PT)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:KRAMER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:637 WASHINGTON STREET
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446
Mailing Address - Country:US
Mailing Address - Phone:617-734-6135
Mailing Address - Fax:617-734-3744
Practice Address - Street 1:637 WASHINGTON STREET
Practice Address - Street 2:SUITE 102
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446
Practice Address - Country:US
Practice Address - Phone:617-734-6135
Practice Address - Fax:617-734-3744
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5243225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0374024Medicaid
Y65207Medicare PIN