Provider Demographics
NPI:1043947708
Name:RAMOS, ELIZABETH ENID
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ENID
Last Name:RAMOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 RIVERDALE AVE STE 10
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-4903
Mailing Address - Country:US
Mailing Address - Phone:929-447-5262
Mailing Address - Fax:929-447-5260
Practice Address - Street 1:1 RIVERDALE AVE STE 10
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-4903
Practice Address - Country:US
Practice Address - Phone:929-447-5262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-03
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator