Healthcare Provider Details

I. General information

NPI: 1730192204
Provider Name (Legal Business Name): FRANCES IVETTE RAMOS-HERBERTH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 WILLARD AVE # 11-S
NEWINGTON CT
06111-2631
US

IV. Provider business mailing address

555 WILLARD AVE # 11-S
NEWINGTON CT
06111-2631
US

V. Phone/Fax

Practice location:
  • Phone: 860-667-6790
  • Fax:
Mailing address:
  • Phone: 860-667-6790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberME103760
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License NumberME 103760
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number2015-02139
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number2015-02139
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: