Provider Demographics
NPI:1790244598
Name:RAMOS, LILY ELENA I
Entity Type:Individual
Prefix:MISS
First Name:LILY
Middle Name:ELENA
Last Name:RAMOS
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 E 147TH ST # 2
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10455-4141
Mailing Address - Country:US
Mailing Address - Phone:917-530-7144
Mailing Address - Fax:
Practice Address - Street 1:506 E 147TH ST # 2
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-4141
Practice Address - Country:US
Practice Address - Phone:917-530-7144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician