MEDICARE: CYRELDA RAMIREZ FERMIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	0101055931	VA

General Provider Information

NPI Number	:	1144214313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYRELDA RAMIREZ FERMIN MD

Provider Business Mailing Address
First Line	:	5632 OLD MILL RD
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22309-3332
Country	:	US
Telephone Number	:	703-619-4901
Fax Number	:

Provider Business Practice Location Address
First Line	:	4010 MAURY PL
Second Line	:	UNIT 8B
City	:	ALEXANDRIA
State	:	VA
Zip	:	22309-2340
Country	:	US
Telephone Number	:	703-619-6357
Fax Number	:	703-619-6358

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2005
Last Update Date	:	07/08/2007

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