Healthcare Provider Details

I. General information

NPI: 1457838575
Provider Name (Legal Business Name): ALLAN RAMIREZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2018
Last Update Date: 12/17/2021
Certification Date: 12/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 W 15TH ST FL 2
NEW YORK NY
10011
US

IV. Provider business mailing address

145 W 15TH ST FL 2
NEW YORK NY
10011-6701
US

V. Phone/Fax

Practice location:
  • Phone: 212-229-6905
  • Fax:
Mailing address:
  • Phone:
  • Fax: 646-477-4094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number104210
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number092546
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: