Provider Demographics
NPI:1467494336
Name:RAMIREZ, MARK A (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 E 208TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2702
Mailing Address - Country:US
Mailing Address - Phone:718-405-1700
Mailing Address - Fax:718-405-7231
Practice Address - Street 1:60 E 208TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2702
Practice Address - Country:US
Practice Address - Phone:718-405-1700
Practice Address - Fax:718-405-7231
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY160970207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0493801025OtherCIGNA
NY160970-B14OtherHEALTHFIRST
NY01067234Medicaid
NY1000001434OtherAFFINITY
NY7200109OtherGHI
NY48F201Medicare ID - Type Unspecified
NYE44896Medicare UPIN