Provider Demographics
NPI:1407278443
Name:ABREU, RAMON
Entity Type:Individual
Prefix:
First Name:RAMON
Middle Name:
Last Name:ABREU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 SUTTER AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11208-3863
Mailing Address - Country:US
Mailing Address - Phone:718-360-7433
Mailing Address - Fax:718-228-7030
Practice Address - Street 1:1200 SUTTER AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-3863
Practice Address - Country:US
Practice Address - Phone:718-360-7433
Practice Address - Fax:718-228-7030
Is Sole Proprietor?:No
Enumeration Date:2014-01-10
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00000000OtherSPECIALIST