1578525960 NPI number — GIOVANNI GRETO RAMOS M.D.

Table of content: GIOVANNI GRETO RAMOS M.D. (NPI 1578525960)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578525960 NPI number — GIOVANNI GRETO RAMOS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAMOS
Provider First Name:
GIOVANNI
Provider Middle Name:
GRETO
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1578525960
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/09/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
157 E WOODSIDE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EAST PATCHOGUE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11772-1421
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-475-1900
Provider Business Mailing Address Fax Number:
570-475-1955

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
157 E WOODSIDE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST PATCHOGUE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11772-1421
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-475-1900
Provider Business Practice Location Address Fax Number:
631-475-1955
Provider Enumeration Date:
04/03/2006

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: 207R00000X , with the licence number:  MD419448 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 331175 , 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: 7092409 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 77750 E465 . This is a "GEISINGER GOLD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0019212380003 . This is a "MEDICAL ASSISTANCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1437433 . This is a "BLUE SHIELD, BC/BS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 77750 E465 . This is a "GEISINGER HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1437433 . This is a "FIRST PRIORITY LIFE" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00239580 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2121722000 . This is a "BC/BS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 002718 . This is a "HMO" identifier . This identifiers is of the category "OTHER".




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