Provider Demographics
NPI:1053434118
Name:RAMOS, RACHELLE HALAGAO (MD)
Entity type:Individual
Prefix:DR
First Name:RACHELLE
Middle Name:HALAGAO
Last Name:RAMOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 NORTH CT
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-2111
Mailing Address - Country:US
Mailing Address - Phone:516-626-9212
Mailing Address - Fax:
Practice Address - Street 1:381 PARK AVE S
Practice Address - Street 2:SUITE 1019
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-8806
Practice Address - Country:US
Practice Address - Phone:212-683-4560
Practice Address - Fax:212-683-4563
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2209792084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02109704Medicaid
NYP2424746OtherOXFORD
NY02109704Medicaid