Basic Information
Provider Information
NPI: 1609884832
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CRAMER
FirstName: JANE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6255 SHERIDAN DR
Address2: SUITE 304
City: WILLIAMSVILLE
State: NY
PostalCode: 142214836
CountryCode: US
TelephoneNumber: 7168578666
FaxNumber: 7168578994
Practice Location
Address1: 325 ESSJAY RD
Address2:  
City: WILLIAMSVILLE
State: NY
PostalCode: 142218243
CountryCode: US
TelephoneNumber: 7166301020
FaxNumber: 7166301278
Other Information
ProviderEnumerationDate: 08/03/2006
LastUpdateDate: 03/13/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X007602-1NYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

ID Information
IDTypeStateIssuerDescription
660015001NYGHIOTHER
935361701NYIHAOTHER
00060531900301NYHEALTH NOWOTHER
0001121600101NYUNIVERAOTHER


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