Provider Demographics
NPI:1467046490
Name:RAMSTECK, MICHAEL BRIAN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:BRIAN
Last Name:RAMSTECK
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 THIRD AVE
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-4535
Mailing Address - Country:US
Mailing Address - Phone:631-745-5853
Mailing Address - Fax:
Practice Address - Street 1:201 THIRD AVE
Practice Address - Street 2:
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-4535
Practice Address - Country:US
Practice Address - Phone:631-745-5853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-20
Last Update Date:2024-03-26
Deactivation Date:2024-02-24
Deactivation Code:
Reactivation Date:2024-03-26
Provider Licenses
StateLicense IDTaxonomies
PAPS019191103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist