Provider Demographics
NPI:1215145081
Name:KRAMER, RONALD CHARLES (RPH)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:CHARLES
Last Name:KRAMER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 HERITAGE HLS UNIT A
Mailing Address - Street 2:
Mailing Address - City:SOMERS
Mailing Address - State:NY
Mailing Address - Zip Code:10589-1317
Mailing Address - Country:US
Mailing Address - Phone:914-277-7799
Mailing Address - Fax:914-276-8481
Practice Address - Street 1:511 ROUTE 52
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-6064
Practice Address - Country:US
Practice Address - Phone:845-225-4242
Practice Address - Fax:845-225-9349
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026283183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRPH026283OtherPHARMACIST LICENSE #
NY01310425Medicaid