Provider Demographics
NPI:1689920605
Name:LOPEZ RAMOS, YANIRA ILEANA (MD)
Entity Type:Individual
Prefix:DR
First Name:YANIRA
Middle Name:ILEANA
Last Name:LOPEZ RAMOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 E 5TH ST
Mailing Address - Street 2:APT #6
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-8561
Mailing Address - Country:US
Mailing Address - Phone:939-339-1981
Mailing Address - Fax:
Practice Address - Street 1:760 BROADWAY
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-5317
Practice Address - Country:US
Practice Address - Phone:718-963-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-27
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY283396207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04491214Medicaid
NYA400150886Medicare PIN