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NPI Code Detail

MEDICARE: AMANDA NICOLE CLARK-RAMIREZ

MEDICARE: AMANDA NICOLE CLARK-RAMIREZ
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
1171M00000XCase Manager/Care CoordinatorNY

General Provider Information

NPI Number : 1578420030
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA NICOLE CLARK-RAMIREZ
Provider Business Mailing Address
First Line : 91 LAKES RD STE 3
Second Line :
City : MONROE
State : NY
Zip : 10950-2694
Country : US
Telephone Number : 845-827-6227
Fax Number :
Provider Business Practice Location Address
First Line : 91 LAKES RD STE 3
Second Line :
City : MONROE
State : NY
Zip : 10950-2694
Country : US
Telephone Number : 845-827-6227
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2026
Last Update Date : 01/07/2026

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Directions to “ AMANDA NICOLE CLARK-RAMIREZ ” Practice Location

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