Provider Demographics
NPI:1275717845
Name:BETANCOURT-RAMIREZ, ALEJANDRO (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEJANDRO
Middle Name:
Last Name:BETANCOURT-RAMIREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-8442
Mailing Address - Country:US
Mailing Address - Phone:631-390-7100
Mailing Address - Fax:631-390-7128
Practice Address - Street 1:100 WOODS RD
Practice Address - Street 2:TAYLOR PAVILION, DEPARTMENT OF SURGERY, TRAUMA DIVISION
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1530
Practice Address - Country:US
Practice Address - Phone:914-493-6624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY274882-12086S0102X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care