MEDICARE: MARIA RAMIREZ

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	363LA2200X	Adult Health Nurse Practitioner	26NJ0057410	NJ
2	363LA2200X	Adult Health Nurse Practitioner	NP#26NJ00574100	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194109819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA RAMIREZ

Provider Business Mailing Address
First Line	:	796 MOUNT PROSPECT AVE
Second Line	:
City	:	NEWARK
State	:	NJ
Zip	:	07104-3223
Country	:	US
Telephone Number	:	973-481-0501
Fax Number	:	973-755-0767

Provider Business Practice Location Address
First Line	:	796 MOUNT PROSPECT AVE
Second Line	:
City	:	NEWARK
State	:	NJ
Zip	:	07104-3223
Country	:	US
Telephone Number	:	734-810-5019
Fax Number	:	973-755-0767

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

Provider Enumeration Date	:	07/13/2015
Last Update Date	:	05/23/2020

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Directions to “ MARIA RAMIREZ ” Practice Location

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