Provider Demographics
NPI:1649263393
Name:CRAMER, JOHN STEVEN (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:STEVEN
Last Name:CRAMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2447 SHERIDAN DR
Mailing Address - Street 2:
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150-9405
Mailing Address - Country:US
Mailing Address - Phone:716-835-9800
Mailing Address - Fax:716-835-9888
Practice Address - Street 1:2447 SHERIDAN DR
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150-9405
Practice Address - Country:US
Practice Address - Phone:716-835-9800
Practice Address - Fax:716-835-9888
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY188480207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01368670Medicaid
NY01368670Medicaid
F49128Medicare UPIN