Provider Demographics
NPI:1285762401
Name:KRAMER, EDWARD R JR (DC)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:R
Last Name:KRAMER
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 STATE ROUTE 94
Mailing Address - Street 2:
Mailing Address - City:BLAIRSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07825-2115
Mailing Address - Country:US
Mailing Address - Phone:908-362-9522
Mailing Address - Fax:908-362-8858
Practice Address - Street 1:174 STATE ROUTE 94
Practice Address - Street 2:
Practice Address - City:BLAIRSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07825-2115
Practice Address - Country:US
Practice Address - Phone:908-362-9522
Practice Address - Fax:908-362-8858
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC 1774111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJKR 445554Medicare ID - Type Unspecified