Provider Demographics
NPI:1285272567
Name:RAMOS, STEVEN MARINO
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:MARINO
Last Name:RAMOS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713A SOUTHERN BLVD # 3
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10455-2105
Mailing Address - Country:US
Mailing Address - Phone:347-803-6455
Mailing Address - Fax:
Practice Address - Street 1:713A SOUTHERN BLVD # 3
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-2105
Practice Address - Country:US
Practice Address - Phone:347-803-6455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY536138494172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver