Provider Demographics
NPI:1285727974
Name:DE RAMON PLASTIC SURGERY INSTITUTE, PC
Entity type:Organization
Organization Name:DE RAMON PLASTIC SURGERY INSTITUTE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:DE RAMON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-791-2880
Mailing Address - Street 1:2025 TECHNOLOGY PARKWAY
Mailing Address - Street 2:SUITE 303
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050
Mailing Address - Country:US
Mailing Address - Phone:717-791-2880
Mailing Address - Fax:717-791-2885
Practice Address - Street 1:2025 TECHNOLOGY PARKWAY
Practice Address - Street 2:SUITE 303
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050
Practice Address - Country:US
Practice Address - Phone:717-791-2880
Practice Address - Fax:717-791-2885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD070908L208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH15069Medicare UPIN
PA061216Medicare ID - Type Unspecified