Provider Demographics
NPI:1528456308
Name:RAMIREZ, ROBERTO JR
Entity type:Individual
Prefix:
First Name:ROBERTO
Middle Name:
Last Name:RAMIREZ
Suffix:JR
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 1:33 ATHBOY DR
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NY
Mailing Address - Zip Code:12542-6516
Mailing Address - Country:US
Mailing Address - Phone:646-251-2446
Mailing Address - Fax:
Practice Address - Street 1:255 ROUTE 32
Practice Address - Street 2:
Practice Address - City:CENTRAL VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10917-3613
Practice Address - Country:US
Practice Address - Phone:845-827-6227
Practice Address - Fax:845-827-6228
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-02
Last Update Date:2015-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist