Provider Demographics
NPI:1992027528
Name:RAMETTA, BENJAMIN ALAN (RPH)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:ALAN
Last Name:RAMETTA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 BROAD STREET
Mailing Address - Street 2:WALGREENS
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801
Mailing Address - Country:US
Mailing Address - Phone:518-793-3040
Mailing Address - Fax:
Practice Address - Street 1:202 BROAD STREET
Practice Address - Street 2:WALGREENS
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801
Practice Address - Country:US
Practice Address - Phone:518-793-3040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-23
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052477183500000X
CTPCT.9921183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist