Provider Demographics
NPI:1013094747
Name:RAMAPO MEDICAL, P.C.
Entity Type:Organization
Organization Name:RAMAPO MEDICAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:S
Authorized Official - Last Name:KAMINETZKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-357-6444
Mailing Address - Street 1:2 EXECUTIVE BLVD
Mailing Address - Street 2:SUITE 404
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-4164
Mailing Address - Country:US
Mailing Address - Phone:845-357-6444
Mailing Address - Fax:845-357-0179
Practice Address - Street 1:2 EXECUTIVE BLVD
Practice Address - Street 2:SUITE 404
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-4164
Practice Address - Country:US
Practice Address - Phone:845-357-6444
Practice Address - Fax:845-357-0179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY194890207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01616788Medicaid
NYG05643Medicare UPIN
NY01616788Medicaid