Provider Demographics
NPI:1487782546
Name:RAMAPO VALLEY OBGYN PC
Entity type:Organization
Organization Name:RAMAPO VALLEY OBGYN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CRAVELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-354-1113
Mailing Address - Street 1:974 ROUTE 45
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-3520
Mailing Address - Country:US
Mailing Address - Phone:845-354-1113
Mailing Address - Fax:845-354-1813
Practice Address - Street 1:974 ROUTE 45
Practice Address - Street 2:SUITE 1000
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3520
Practice Address - Country:US
Practice Address - Phone:845-354-1113
Practice Address - Fax:845-354-1813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWJD371Medicare PIN