Healthcare Provider Details

I. General information

NPI: 1003351644
Provider Name (Legal Business Name): DAVID RAMOS CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2017
Last Update Date: 03/23/2022
Certification Date: 03/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 SOUTH CAYUGA RD
WILLIAMSVILLE NY
14221
US

IV. Provider business mailing address

4404 FIELDGREEN RD
NOTTINGHAM MD
21236-1815
US

V. Phone/Fax

Practice location:
  • Phone: 716-632-1088
  • Fax: 716-632-7842
Mailing address:
  • Phone: 716-263-3946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number726181
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number0024182955
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: