Provider Demographics
NPI:1518981448
Name:RAMIREZ, GILBERTO (MD)
Entity Type:Individual
Prefix:
First Name:GILBERTO
Middle Name:
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 1:421 COTTAGE GROVE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-3119
Mailing Address - Country:US
Mailing Address - Phone:860-242-3933
Mailing Address - Fax:860-242-3301
Practice Address - Street 1:421 COTTAGE GROVE RD
Practice Address - Street 2:SUITE A
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-3119
Practice Address - Country:US
Practice Address - Phone:860-242-3933
Practice Address - Fax:860-242-3301
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT028497207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001284976Medicaid
CT010028497CT04OtherANTHEM BLUE SHIELD
CT010028497CT04OtherANTHEM BLUE SHIELD
CT001284976Medicaid