Provider Demographics
NPI:1902651011
Name:TICO CALZADA, RAMON (MD)
Entity type:Individual
Prefix:
First Name:RAMON
Middle Name:
Last Name:TICO CALZADA
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:CONDOMINIO CERRO ALTO 107
Mailing Address - Street 2:
Mailing Address - City:ESCAZU
Mailing Address - State:SAN JOSE
Mailing Address - Zip Code:10203
Mailing Address - Country:CR
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:79-01 BROADWAY ELMHURST HOSP CTR-MOUNT SINAI
Practice Address - Street 2:RM D6-04
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373
Practice Address - Country:US
Practice Address - Phone:718-334-3437
Practice Address - Fax:718-334-4904
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program