Provider Demographics
NPI:1104532530
Name:KRAMER, JUSTINE (RDN, LDN)
Entity type:Individual
Prefix:
First Name:JUSTINE
Middle Name:
Last Name:KRAMER
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 GREEN GARDEN DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-6524
Mailing Address - Country:US
Mailing Address - Phone:330-550-8736
Mailing Address - Fax:
Practice Address - Street 1:514 GREEN GARDEN DR
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-6524
Practice Address - Country:US
Practice Address - Phone:330-550-8736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH86330863133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty