1417611906 NPI number — JOEL RAMOS MORALES APRN

Table of content: JOEL RAMOS MORALES APRN (NPI 1417611906)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417611906 NPI number — JOEL RAMOS MORALES APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAMOS MORALES
Provider First Name:
JOEL
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417611906
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/18/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 211226
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WOODHAVEN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11421-6226
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-805-0037
Provider Business Mailing Address Fax Number:
866-221-0879

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1052 LIBERTY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11208-2913
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-805-0037
Provider Business Practice Location Address Fax Number:
866-221-0879
Provider Enumeration Date:
10/29/2021

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: 363LF0000X , with the licence number:  F357158 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 117816600 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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