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General NPI Number Information
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NPI Number | 1629178843
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Entity Type | Individual
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Provider Name | RANDOLPH RAMIREZ MD
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Gender | Male
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 10/27/2010
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Provider Practice Location Address
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Address Line | 2103 MAIN STREET
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City | STRATFORD
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State | CT
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Zip | 06115
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Country | US
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Telephone | 203-377-3666
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Fax | 203-377-6500
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Provider Business Mailing Address
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Address Line | 68 WEPAWAUG RD
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City | WOODBRIDGE
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State | CT
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Zip | 06525-2423
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Country | US
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Telephone | 203-298-9309
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 031878
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License Number State | CT
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