Provider Demographics
NPI:1568155968
Name:RAMOS, DANITZA
Entity Type:Individual
Prefix:
First Name:DANITZA
Middle Name:
Last Name:RAMOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 PARK PL
Mailing Address - Street 2:
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094-3654
Mailing Address - Country:US
Mailing Address - Phone:201-325-9277
Mailing Address - Fax:201-325-9347
Practice Address - Street 1:400 PARK PL
Practice Address - Street 2:
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094-3654
Practice Address - Country:US
Practice Address - Phone:201-325-9277
Practice Address - Fax:201-325-9347
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
156FX1800X
NJ3TD00418100156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician