Provider Demographics
NPI:1497412993
Name:RAMIREZ, LAURA L (NP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:L
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 TRUXTON RD
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-6827
Mailing Address - Country:US
Mailing Address - Phone:917-592-8445
Mailing Address - Fax:
Practice Address - Street 1:421 DEER PARK AVE
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-2313
Practice Address - Country:US
Practice Address - Phone:917-592-8445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY732209-01163W00000X
NYF348171-01364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health
No163W00000XNursing Service ProvidersRegistered Nurse