Provider Demographics
NPI:1346485034
Name:RAMIREZ, RODNEY (CASAS)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:CASAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-5018
Mailing Address - Country:US
Mailing Address - Phone:212-533-3570
Mailing Address - Fax:212-780-5559
Practice Address - Street 1:315 E 10TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-5018
Practice Address - Country:US
Practice Address - Phone:212-533-3570
Practice Address - Fax:212-780-5559
Is Sole Proprietor?:No
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY19891101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02772705Medicaid