Healthcare Provider Details

I. General information

NPI: 1568772390
Provider Name (Legal Business Name): ORLANDO RAMOS LCADC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2010
Last Update Date: 10/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 PARK AVENUE
PLAINFIELD NJ
07060
US

IV. Provider business mailing address

1010 PARK AVENUE
PLAINFIELD NJ
07060
US

V. Phone/Fax

Practice location:
  • Phone: 908-822-9099
  • Fax: 908-822-0449
Mailing address:
  • Phone: 908-822-9099
  • Fax: 908-822-0449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number37LC00166800
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: