Healthcare Provider Details

I. General information

NPI: 1043141575
Provider Name (Legal Business Name): REBECCA RAMDASS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 GRAHAM AVE
BROOKLYN NY
11211-4904
US

IV. Provider business mailing address

145 DUPONT ST
BROOKLYN NY
11222-1277
US

V. Phone/Fax

Practice location:
  • Phone: 917-310-3371
  • Fax:
Mailing address:
  • Phone: 347-440-2645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number035802-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: