Provider Demographics
NPI:1740435924
Name:RAMOS FOOT AND ANKLE CENTER LLC
Entity type:Organization
Organization Name:RAMOS FOOT AND ANKLE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FAUSTO
Authorized Official - Middle Name:J
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:732-442-6444
Mailing Address - Street 1:474 AMBOY AVE
Mailing Address - Street 2:2ND FLR
Mailing Address - City:PERTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08861-3145
Mailing Address - Country:US
Mailing Address - Phone:732-442-6444
Mailing Address - Fax:732-442-6449
Practice Address - Street 1:474 AMBOY AVE
Practice Address - Street 2:2ND FLR
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-3145
Practice Address - Country:US
Practice Address - Phone:732-442-6444
Practice Address - Fax:732-442-6449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-01
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00287000213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJDP3958OtherRAIL ROAD MEDICARE GROUP PTAN
NJV09563Medicare UPIN
NJ140358Medicare PIN
NJ6180650001Medicare NSC