Provider Demographics
NPI:1144500125
Name:KREMER, ALEXANDER (LAC)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:KREMER
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 BYBERRY RD APT L108
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19116-4022
Mailing Address - Country:US
Mailing Address - Phone:267-753-5337
Mailing Address - Fax:800-448-2595
Practice Address - Street 1:1300 INDUSTRIAL BLVD STE 100A
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-4029
Practice Address - Country:US
Practice Address - Phone:267-753-5337
Practice Address - Fax:800-448-2595
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-23
Last Update Date:2021-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI892171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist