Healthcare Provider Details

I. General information

NPI: 1881455350
Provider Name (Legal Business Name): ANDREA RAMIREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2024
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 CENTERVILLE RD STE 2
WARWICK RI
02886-4336
US

IV. Provider business mailing address

PO BOX 229
WAKEFIELD RI
02880-0229
US

V. Phone/Fax

Practice location:
  • Phone: 401-562-1020
  • Fax: 401-562-1056
Mailing address:
  • Phone: 401-788-3929
  • Fax: 401-788-3939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: