Provider Demographics
NPI:1346257490
Name:RAMOS-BONNER, LUZ S (MD)
Entity Type:Individual
Prefix:DR
First Name:LUZ
Middle Name:S
Last Name:RAMOS-BONNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LUZ
Other - Middle Name:S
Other - Last Name:RAMOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:326 PALTON RD
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-1644
Mailing Address - Country:US
Mailing Address - Phone:215-355-5311
Mailing Address - Fax:
Practice Address - Street 1:6970 GERMANTOWN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19119-2114
Practice Address - Country:US
Practice Address - Phone:215-951-4586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08127600282N00000X
NJ25MAO8127600207RG0300X
PAMD431039207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care HospitalGroup - Single Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0131814Medicaid
NJ260744826OtherBLUE CROSS
111963Medicare PIN