Provider Demographics
NPI:1093703696
Name:RAMIREZ, ALVARO (MD)
Entity Type:Individual
Prefix:DR
First Name:ALVARO
Middle Name:
Last Name:RAMIREZ
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 1:105 LEXINGTON AVE
Mailing Address - Street 2:APT 11A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-8963
Mailing Address - Country:US
Mailing Address - Phone:212-684-7146
Mailing Address - Fax:212-684-7146
Practice Address - Street 1:8818 37TH AVE
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7737
Practice Address - Country:US
Practice Address - Phone:718-898-6108
Practice Address - Fax:718-335-5352
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-09
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205040207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01828591Medicaid
NY01828591Medicaid