Provider Demographics
NPI:1164104915
Name:RAMLAKAN, DOODMATTIE
Entity Type:Individual
Prefix:
First Name:DOODMATTIE
Middle Name:
Last Name:RAMLAKAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19664 67TH AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-3943
Mailing Address - Country:US
Mailing Address - Phone:646-641-7948
Mailing Address - Fax:
Practice Address - Street 1:196-64 67TH AVENUE, 2ND FLOOR
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11365
Practice Address - Country:US
Practice Address - Phone:631-401-3713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY119852104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker