Provider Demographics
NPI:1003476573
Name:RAMPERSAD-FELICIANO, NICOLE (MS, BS)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:
Last Name:RAMPERSAD-FELICIANO
Suffix:
Gender:F
Credentials:MS, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22036 73RD AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-2624
Mailing Address - Country:US
Mailing Address - Phone:347-336-1295
Mailing Address - Fax:
Practice Address - Street 1:706 QUINCY ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11221-2210
Practice Address - Country:US
Practice Address - Phone:718-443-3440
Practice Address - Fax:718-993-4999
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-17
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2685608174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty