Healthcare Provider Details

I. General information

NPI: 1598690463
Provider Name (Legal Business Name): ANDREW RAMOS DUBONGCO AGPCNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 55TH ST
BROOKLYN NY
11220-2508
US

IV. Provider business mailing address

7609 4TH AVE APT F7
BROOKLYN NY
11209-3236
US

V. Phone/Fax

Practice location:
  • Phone: 718-630-7000
  • Fax:
Mailing address:
  • Phone: 845-367-3166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF312793-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: