Healthcare Provider Details

I. General information

NPI: 1346257490
Provider Name (Legal Business Name): LUZ S RAMOS-BONNER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LUZ S RAMOS M.D.

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 11/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6970 GERMANTOWN AVE
PHILADELPHIA PA
19119-2114
US

IV. Provider business mailing address

326 PALTON RD
BENSALEM PA
19020-1644
US

V. Phone/Fax

Practice location:
  • Phone: 215-951-4586
  • Fax:
Mailing address:
  • Phone: 215-355-5311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number25MA08127600
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number25MAO8127600
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberMD431039
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: