Healthcare Provider Details

I. General information

NPI: 1518874460
Provider Name (Legal Business Name): CORAIMA RAMIREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 GROVE AVE STE 216
CEDARHURST NY
11516-2302
US

IV. Provider business mailing address

1110 JACKSON AVE APT 1
BRONX NY
10456-5493
US

V. Phone/Fax

Practice location:
  • Phone: 516-350-8564
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP125492
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: