MEDICARE: ROBERTO ALEX RAMOS JR.

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	104100000X	Social Worker	9831	CT

General Provider Information

NPI Number	:	1639983562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERTO ALEX RAMOS JR.

Provider Business Mailing Address
First Line	:	235 TYLER ST
Second Line	:
City	:	EAST HAVEN
State	:	CT
Zip	:	06512-2954
Country	:	US
Telephone Number	:	203-909-3086
Fax Number	:

Provider Business Practice Location Address
First Line	:	235 TYLER ST
Second Line	:
City	:	EAST HAVEN
State	:	CT
Zip	:	06512-2954
Country	:	US
Telephone Number	:	203-909-3086
Fax Number	:

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

Provider Enumeration Date	:	02/03/2025
Last Update Date	:	02/03/2025

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