Basic Information
| Provider Information | |||||||||
| NPI: | 1316954050 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KRAMER PHYSICAL THERAPY ASSOCIATES INC | ||||||||
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| OtherOrganizationName: | KRAMER PHYSICAL THERAPY ASSOCIATES | ||||||||
| OtherOrganizationType: | 4 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 637 WASHINGTON ST | ||||||||
| Address2: | STE 102 | ||||||||
| City: | BROOKLINE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024464579 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 637 WASHINGTON ST | ||||||||
| Address2: | STE 102 | ||||||||
| City: | BROOKLINE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024464579 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177346135 | ||||||||
| FaxNumber: | 6177343744 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/02/2006 | ||||||||
| LastUpdateDate: | 11/19/2007 | ||||||||
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| AuthorizedOfficialLastName: | KRAMER | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6177346135 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | PT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 94 | MA | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 9758640 | 05 | MA | MEDICAID |