Provider Demographics
NPI:1891792065
Name:RAMOS, DANTE A (MD)
Entity type:Individual
Prefix:DR
First Name:DANTE
Middle Name:A
Last Name:RAMOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-4429
Mailing Address - Country:US
Mailing Address - Phone:401-728-9208
Mailing Address - Fax:401-724-3710
Practice Address - Street 1:126 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-4429
Practice Address - Country:US
Practice Address - Phone:401-728-9208
Practice Address - Fax:401-724-3710
Is Sole Proprietor?:No
Enumeration Date:2005-07-03
Last Update Date:2007-07-08
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-03-28
Provider Licenses
StateLicense IDTaxonomies
RIRI-45242080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIMD 04524OtherSTATE MEDICAL LICENSE NO.
RIMD 04524OtherSTATE MEDICAL LICENSE NO.