Provider Demographics
NPI:1396724449
Name:RAMADAN, BERRYZAD EZZAT (MD)
Entity type:Individual
Prefix:DR
First Name:BERRYZAD
Middle Name:EZZAT
Last Name:RAMADAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 NEW FLETCHER ST
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-2816
Mailing Address - Country:US
Mailing Address - Phone:978-250-1097
Mailing Address - Fax:978-453-3289
Practice Address - Street 1:198 LITTLETON RD
Practice Address - Street 2:
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-3408
Practice Address - Country:US
Practice Address - Phone:978-746-6382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2019-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA217120208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAH95068Medicare UPIN
MARA A36094Medicare ID - Type Unspecified