Provider Demographics
NPI:1912669201
Name:RAMALES-PEREZ, OLGA (LSW)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:RAMALES-PEREZ
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 N BAY AVE
Mailing Address - Street 2:
Mailing Address - City:BEACH HAVEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08008-1923
Mailing Address - Country:US
Mailing Address - Phone:609-389-0284
Mailing Address - Fax:
Practice Address - Street 1:700 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5907
Practice Address - Country:US
Practice Address - Phone:732-367-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-13
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SLO6709700104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0029807Medicaid