Healthcare Provider Details

I. General information

NPI: 1891792065
Provider Name (Legal Business Name): DANTE A. RAMOS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date: 03/20/2006
Reactivation Date: 03/28/2006

III. Provider practice location address

126 PROSPECT ST
PAWTUCKET RI
02860-4429
US

IV. Provider business mailing address

126 PROSPECT ST
PAWTUCKET RI
02860-4429
US

V. Phone/Fax

Practice location:
  • Phone: 401-728-9208
  • Fax: 401-724-3710
Mailing address:
  • Phone: 401-728-9208
  • Fax: 401-724-3710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberRI-4524
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: