Healthcare Provider Details

I. General information

NPI: 1275604563
Provider Name (Legal Business Name): LUIS A RAMIREZ-PACHECO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 06/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 32ND ST APT 1
UNION CITY NJ
07087-3966
US

IV. Provider business mailing address

404 32ND ST APT 1
UNION CITY NJ
07087-3966
US

V. Phone/Fax

Practice location:
  • Phone: 201-758-7530
  • Fax: 201-758-7529
Mailing address:
  • Phone: 201-758-7530
  • Fax: 201-758-7529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License NumberMA50521
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: