Provider Demographics
NPI:1790956142
Name:RAMHARRACK, DONNA V (NP)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:V
Last Name:RAMHARRACK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:POB 1061
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-1061
Mailing Address - Country:US
Mailing Address - Phone:516-390-9640
Mailing Address - Fax:516-390-9650
Practice Address - Street 1:100 PORT WASHINGTON BLVD.
Practice Address - Street 2:SUITE 105
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576-1353
Practice Address - Country:US
Practice Address - Phone:516-390-9640
Practice Address - Fax:516-390-9650
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-13
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY303747363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner