1831538412 NPI number — AMIE B RAMOS

Table of content: AMIE B RAMOS (NPI 1831538412)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831538412 NPI number — AMIE B RAMOS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAMOS
Provider First Name:
AMIE
Provider Middle Name:
B
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

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:
1831538412
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/26/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
68 S SERVICE RD
Provider Second Line Business Mailing Address:
SUITE 350
Provider Business Mailing Address City Name:
MELVILLE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11747-2358
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-945-3000
Provider Business Mailing Address Fax Number:
516-945-3131

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4320 SEMINARY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALEXANDRIA
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22304-1535
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-504-3789
Provider Business Practice Location Address Fax Number:
703-295-9369
Provider Enumeration Date:
06/18/2013

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: 367500000X , with the licence number:  0001244446 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1831538412 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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