Provider Demographics
NPI:1992238737
Name:BURGOS, RAMON LUIS (MD)
Entity type:Individual
Prefix:DR
First Name:RAMON
Middle Name:LUIS
Last Name:BURGOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1051 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-1007
Mailing Address - Country:US
Mailing Address - Phone:939-579-1769
Mailing Address - Fax:
Practice Address - Street 1:251 CENTRAL PARK W SUITE 1A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-4111
Practice Address - Country:US
Practice Address - Phone:917-451-1062
Practice Address - Fax:917-900-1419
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-08
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2961032084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry