Healthcare Provider Details

I. General information

NPI: 1114993532
Provider Name (Legal Business Name): RAMON RAFER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2006
Last Update Date: 11/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 WILLOW AVE
HOBOKEN NJ
07030-3808
US

IV. Provider business mailing address

PO BOX 51020
NEWARK NJ
07101-5120
US

V. Phone/Fax

Practice location:
  • Phone: 201-945-2481
  • Fax: 201-943-8105
Mailing address:
  • Phone: 201-945-2481
  • Fax: 201-943-8105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MA06451200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: