Healthcare Provider Details

I. General information

NPI: 1548173594
Provider Name (Legal Business Name): JAILYN RAMPERSAUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3045 BUHRE AVE
BRONX NY
10461-4762
US

IV. Provider business mailing address

301 OLD TOWN RD
BRIDGEPORT CT
06606-1544
US

V. Phone/Fax

Practice location:
  • Phone: 917-830-4317
  • Fax:
Mailing address:
  • Phone: 914-562-7592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: