Provider Demographics
NPI:1619157575
Name:RAMIREZ, MANUEL (RPH)
Entity Type:Individual
Prefix:MR
First Name:MANUEL
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4953 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10034-2303
Mailing Address - Country:US
Mailing Address - Phone:212-569-1230
Mailing Address - Fax:212-569-2169
Practice Address - Street 1:4943 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10034-2303
Practice Address - Country:US
Practice Address - Phone:212-569-1230
Practice Address - Fax:212-569-2169
Is Sole Proprietor?:No
Enumeration Date:2007-11-08
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040769-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist