1710524202 NPI number — JEFFREY RAMIREZ

Table of content: DR. GAIL ELLEN MARASSE DC, PHD (NPI 1316159957)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710524202 NPI number — JEFFREY RAMIREZ

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAMIREZ
Provider First Name:
JEFFREY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
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:
1710524202
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/04/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16 MAYBROOK RD STE L
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAMPBELL HALL
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10916-2741
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-636-4344
Provider Business Mailing Address Fax Number:
845-636-4355

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 E ECKERSON RD STE 290
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW CITY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10956-7153
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-578-9898
Provider Business Practice Location Address Fax Number:
845-578-9899
Provider Enumeration Date:
12/04/2019

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: 225100000X , with the licence number:  045317 , 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)