Provider Demographics
NPI:1114700515
Name:FELIU DISLA, RAMON ANTONIO (RPH)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:ANTONIO
Last Name:FELIU DISLA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:DR
Other - First Name:RAMON
Other - Middle Name:ANTONIO
Other - Last Name:FELIU DISLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPHRAMON FELIU DISLA
Mailing Address - Street 1:809 E 6TH ST APT 5D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-7038
Mailing Address - Country:US
Mailing Address - Phone:347-784-7216
Mailing Address - Fax:
Practice Address - Street 1:809 E 6TH ST APT 5D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-7038
Practice Address - Country:US
Practice Address - Phone:347-784-7216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070513183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist