Provider Demographics
NPI:1154756773
Name:RAMPERSAD, ANITRA (RDH)
Entity type:Individual
Prefix:MS
First Name:ANITRA
Middle Name:
Last Name:RAMPERSAD
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13802 QUEENS BLVD
Mailing Address - Street 2:
Mailing Address - City:BRIARWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11435-2642
Mailing Address - Country:US
Mailing Address - Phone:718-298-5100
Mailing Address - Fax:718-657-1870
Practice Address - Street 1:751 BRIGGS HWY
Practice Address - Street 2:
Practice Address - City:ELLENVILLE
Practice Address - State:NY
Practice Address - Zip Code:12428-5501
Practice Address - Country:US
Practice Address - Phone:845-647-2000
Practice Address - Fax:647-647-2302
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-13
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024751124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist