Provider Demographics
NPI:1053854828
Name:RAMNARINE, TRICIA (PA-C)
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:
Last Name:RAMNARINE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1153 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-3446
Mailing Address - Country:US
Mailing Address - Phone:617-983-7300
Mailing Address - Fax:
Practice Address - Street 1:388 E FORDHAM RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-5044
Practice Address - Country:US
Practice Address - Phone:718-489-3553
Practice Address - Fax:718-489-3554
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-29
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021153363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant