Provider Demographics
NPI:1093842965
Name:RAMOS, ELISHA A (RPAC)
Entity Type:Individual
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First Name:ELISHA
Middle Name:A
Last Name:RAMOS
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Gender:F
Credentials:RPAC
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Mailing Address - Street 1:141 SPRINGMEADOW DR
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11741-3023
Mailing Address - Country:US
Mailing Address - Phone:516-446-1509
Mailing Address - Fax:631-444-8007
Practice Address - Street 1:STONY BROOK UNIVERSITY HOSPITAL
Practice Address - Street 2:HSCT-19, ROOM 040
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-0001
Practice Address - Country:US
Practice Address - Phone:631-444-2209
Practice Address - Fax:631-444-3831
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2013-10-22
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Provider Licenses
StateLicense IDTaxonomies
NY010765363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant