Provider Demographics
NPI:1376925917
Name:ROPER, ROBERTA RAMSEY (PHD)
Entity Type:Individual
Prefix:
First Name:ROBERTA
Middle Name:RAMSEY
Last Name:ROPER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 BROADWAY 7 DN
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024
Mailing Address - Country:US
Mailing Address - Phone:917-699-2749
Mailing Address - Fax:
Practice Address - Street 1:2211 BROADWAY
Practice Address - Street 2:7DN
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6263
Practice Address - Country:US
Practice Address - Phone:917-699-2749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-19
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00009614101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health