Provider Demographics
NPI:1952500175
Name:RAMON VALLARINO MD PC
Entity Type:Organization
Organization Name:RAMON VALLARINO MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLARINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-627-5714
Mailing Address - Street 1:816 8TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215
Mailing Address - Country:US
Mailing Address - Phone:718-788-5762
Mailing Address - Fax:718-499-3753
Practice Address - Street 1:816 8TH AVENUE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215
Practice Address - Country:US
Practice Address - Phone:718-788-5762
Practice Address - Fax:718-499-3753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY126947208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01756041Medicaid
NY00324612Medicaid
NY00324612Medicaid
NY01756041Medicaid
NYB12398Medicare UPIN
NY292023Medicare PIN
NYWYYYV1Medicare PIN