Provider Demographics
NPI:1659646289
Name:RAMIREZ, GILLIE A (RN)
Entity Type:Individual
Prefix:MS
First Name:GILLIE
Middle Name:A
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12110 ROCKAWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTH OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11420-2427
Mailing Address - Country:US
Mailing Address - Phone:718-925-0310
Mailing Address - Fax:718-925-0360
Practice Address - Street 1:12110 ROCKAWAY BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11420-2427
Practice Address - Country:US
Practice Address - Phone:718-925-0310
Practice Address - Fax:718-925-0360
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-15
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5190441163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse