Provider Demographics
NPI:1477545473
Name:RAMONE, LOUISA POLO (MD , FAAP)
Entity Type:Individual
Prefix:DR
First Name:LOUISA
Middle Name:POLO
Last Name:RAMONE
Suffix:
Gender:F
Credentials:MD , FAAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1516 BEVERLEY RD
Mailing Address - Street 2:1ST FLOOR SUITE
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-4516
Mailing Address - Country:US
Mailing Address - Phone:718-287-6400
Mailing Address - Fax:718-287-0125
Practice Address - Street 1:1516 BEVERLEY RD
Practice Address - Street 2:1ST FLOOR SUITE
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-4516
Practice Address - Country:US
Practice Address - Phone:718-287-6400
Practice Address - Fax:718-287-0125
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-17
Last Update Date:2014-01-13
Deactivation Date:2006-03-23
Deactivation Code:
Reactivation Date:2006-03-28
Provider Licenses
StateLicense IDTaxonomies
NY144776208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00647989Medicaid
NYB18632Medicare UPIN
NY69A461Medicare ID - Type Unspecified