Provider Demographics
NPI:1922038025
Name:RAMIREZ, JOANNE (OD)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:286 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07407-2014
Mailing Address - Country:US
Mailing Address - Phone:201-797-5835
Mailing Address - Fax:201-797-2066
Practice Address - Street 1:286 MARKET ST
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07407-2014
Practice Address - Country:US
Practice Address - Phone:201-797-5835
Practice Address - Fax:201-797-2066
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV006836-1152W00000X
NJ27OM00096700152W00000X
NJ27OA00594900152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0091995Medicaid
NJ0091995Medicaid