MEDICARE: DR. JANETTE ROSALIA RAMOS-ACOSTA PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	016798	NY

General Provider Information

NPI Number	:	1033380076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANETTE ROSALIA RAMOS-ACOSTA PH.D.

Provider Business Mailing Address
First Line	:	400 ASPEN KNOLLS WAY
Second Line	:	APT B3
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-6625
Country	:	US
Telephone Number	:	718-812-8314
Fax Number	:

Provider Business Practice Location Address
First Line	:	1110 SOUTH AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-3403
Country	:	US
Telephone Number	:	609-795-1997
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2008
Last Update Date	:	02/04/2021

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