Provider Demographics
NPI:1609924380
Name:RAMAPO OPHTHALMOLOGY ASSOCIATES, LLP
Entity Type:Organization
Organization Name:RAMAPO OPHTHALMOLOGY ASSOCIATES, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:N
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-362-1450
Mailing Address - Street 1:3 MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-3516
Mailing Address - Country:US
Mailing Address - Phone:845-362-1450
Mailing Address - Fax:845-362-3830
Practice Address - Street 1:3 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3516
Practice Address - Country:US
Practice Address - Phone:845-362-1450
Practice Address - Fax:845-362-3830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY198639174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY008133OtherGHI PPO
26770OtherSPECTERA
NY02202748Medicaid
NY4546927OtherAETNA GROUP ID
CJ5729OtherRAILROAD MEDICARE
NY008133OtherGHI HMO
NY4546927OtherAETNA GROUP ID
NYW86931Medicare ID - Type UnspecifiedGROUP ID
NJ067446Medicare PIN
26770OtherSPECTERA
NYC10611Medicare UPIN