Healthcare Provider Details

I. General information

NPI: 1831960442
Provider Name (Legal Business Name): CATHERINE NOELLA RAMOS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2024
Last Update Date: 01/11/2024
Certification Date: 01/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 SOUTHERN BLVD
BRONX NY
10455-4911
US

IV. Provider business mailing address

2010 BRUCKNER BLVD APT 11D
BRONX NY
10473-1908
US

V. Phone/Fax

Practice location:
  • Phone: 718-585-8013
  • Fax: 718-585-8019
Mailing address:
  • Phone: 917-583-1617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number4310001
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4310001
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: