Provider Demographics
NPI:1235217621
Name:RAMOS, MARISOL (PA)
Entity Type:Individual
Prefix:MRS
First Name:MARISOL
Middle Name:
Last Name:RAMOS
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 1:173 FORT WASHINGTON AVE # LL1
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3739
Mailing Address - Country:US
Mailing Address - Phone:646-317-4301
Mailing Address - Fax:
Practice Address - Street 1:173 FORT WASHINGTON AVE # LL1
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3739
Practice Address - Country:US
Practice Address - Phone:646-317-4301
Practice Address - Fax:646-967-0200
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009933363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical