Provider Demographics
NPI:1912980509
Name:KRAMER, FAITH (RN,CF)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:
Last Name:KRAMER
Suffix:
Gender:F
Credentials:RN,CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 CANTERBURY RD
Mailing Address - Street 2:
Mailing Address - City:MARBLEHEAD
Mailing Address - State:MA
Mailing Address - Zip Code:01945-1003
Mailing Address - Country:US
Mailing Address - Phone:781-639-0049
Mailing Address - Fax:781-631-7053
Practice Address - Street 1:79 HIGHLAND AVE
Practice Address - Street 2:SUITE 216
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2711
Practice Address - Country:US
Practice Address - Phone:781-592-7457
Practice Address - Fax:781-631-7053
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-28
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAD/N/A332B00000X
222Z00000X, 225000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA601336OtherTUFTS
MA1534009Medicaid
MA336454OtherBLUE CROSS OF MASS
MA703042OtherHARVARD PILGRIM
MA1534009Medicaid