Provider Demographics
NPI:1124014220
Name:RAMADON UNGER, NATALIE (PA)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:RAMADON UNGER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99A CIRCULAR AVE
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06514-4004
Mailing Address - Country:US
Mailing Address - Phone:203-230-4160
Mailing Address - Fax:203-230-4169
Practice Address - Street 1:325 BOSTON POST ROAD
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477-3504
Practice Address - Country:US
Practice Address - Phone:203-795-0568
Practice Address - Fax:203-795-0436
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000616363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
S50254Medicare UPIN
CT970001664Medicare ID - Type Unspecified