1326692450 NPI number — MR. ANDY JOHN MARCELO CAYTON RAMOS CRNP

Table of content: MR. ANDY JOHN MARCELO CAYTON RAMOS CRNP (NPI 1326692450)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326692450 NPI number — MR. ANDY JOHN MARCELO CAYTON RAMOS CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAMOS
Provider First Name:
ANDY JOHN MARCELO
Provider Middle Name:
CAYTON
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
CRNP
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RAMOS
Provider Other First Name:
ANDY JOHN
Provider Other Middle Name:
CAYTON
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
CRNP
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1326692450
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/26/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9407 GEORGIA BELLE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PERRY HALL
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21128-8819
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-256-9178
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4155 GLEN PARK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NOTTINGHAM
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21236-1019
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-248-0661
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/26/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP2300X , with the licence number:  161121 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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