Healthcare Provider Details

I. General information

NPI: 1649465196
Provider Name (Legal Business Name): RAMIC MAHWAH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 FRANKLIN TURNPIKE SUITE B
MAHWAH NJ
07430
US

IV. Provider business mailing address

400 FRANKLIN TURNPIKE SUITE B
MAHWAH NJ
07430
US

V. Phone/Fax

Practice location:
  • Phone: 207-760-9500
  • Fax: 201-760-0295
Mailing address:
  • Phone: 207-760-9500
  • Fax: 201-760-0295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberPENDING
License Number StateNJ

VIII. Authorized Official

Name: STEVEN JEFFREY MEYERSON
Title or Position: OWNER/ MEDICAL DIRECTOR
Credential: MD
Phone: 201-760-9500