Provider Demographics
NPI:1700586757
Name:MASSOUD, RAMY GEORGE GERIS
Entity Type:Individual
Prefix:
First Name:RAMY
Middle Name:GEORGE GERIS
Last Name:MASSOUD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6123 217TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GDNS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-2233
Mailing Address - Country:US
Mailing Address - Phone:714-988-5145
Mailing Address - Fax:
Practice Address - Street 1:6123 217TH ST FL 2
Practice Address - Street 2:
Practice Address - City:OAKLAND GDNS
Practice Address - State:NY
Practice Address - Zip Code:11364-2233
Practice Address - Country:US
Practice Address - Phone:714-988-5145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant