Basic Information
| Provider Information | |||||||||
| NPI: | 1649465196 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RAMIC MAHWAH, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 400 FRANKLIN TURNPIKE | ||||||||
| Address2: | SUITE B | ||||||||
| City: | MAHWAH | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07430 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2077609500 | ||||||||
| FaxNumber: | 2017600295 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 FRANKLIN TURNPIKE | ||||||||
| Address2: | SUITE B | ||||||||
| City: | MAHWAH | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07430 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2077609500 | ||||||||
| FaxNumber: | 2017600295 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/07/2007 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | MEYERSON | ||||||||
| AuthorizedOfficialFirstName: | STEVEN | ||||||||
| AuthorizedOfficialMiddleName: | JEFFREY | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/ MEDICAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 2017609500 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | FEG, LLC | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | PENDING | NJ | Y | Ambulatory Health Care Facilities | Clinic/Center |
No ID Information.