MEDICARE: MIRIAM RAMIREZ D.D.S

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	122300000X	Dentist	50054099	NY

General Provider Information

NPI Number	:	1508013350
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIRIAM RAMIREZ D.D.S

Provider Business Mailing Address
First Line	:	1727 WHITE PLAINS RD
Second Line	:	SECOND FLOOR
City	:	BRONX
State	:	NY
Zip	:	10462-3802
Country	:	US
Telephone Number	:	347-657-1927
Fax Number	:

Provider Business Practice Location Address
First Line	:	1727 WHITE PLAINS RD
Second Line	:	SECOND FLOOR
City	:	BRONX
State	:	NY
Zip	:	10462-3802
Country	:	US
Telephone Number	:	347-657-1927
Fax Number	:

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

Provider Enumeration Date	:	08/23/2008
Last Update Date	:	06/25/2014

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