Healthcare Provider Details

I. General information

NPI: 1033197280
Provider Name (Legal Business Name): RAMONA ANG YUBONTOY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2006
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 VANDERBILT AVE
STATEN ISLAND NY
10304-2521
US

IV. Provider business mailing address

392 ISABELLA AVE
STATEN ISLAND NY
10306-4544
US

V. Phone/Fax

Practice location:
  • Phone: 917-842-3183
  • Fax: 718-616-0935
Mailing address:
  • Phone: 718-351-1268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number151577
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: