Provider Demographics
NPI:1760570238
Name:RAMMAH, TAREK (MD)
Entity Type:Individual
Prefix:DR
First Name:TAREK
Middle Name:
Last Name:RAMMAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:273 94TH ST
Mailing Address - Street 2:MERCY MEDICAL CARE PC
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-6807
Mailing Address - Country:US
Mailing Address - Phone:718-630-5552
Mailing Address - Fax:718-630-5558
Practice Address - Street 1:273 94TH ST
Practice Address - Street 2:MERCY MEDICAL CARE PC
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-6807
Practice Address - Country:US
Practice Address - Phone:718-630-5552
Practice Address - Fax:718-630-5558
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY228984207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02652844Medicaid
NYI21864Medicare UPIN
NY02652844Medicaid