Basic Information
Provider Information
NPI: 1972603983
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAMSEY
FirstName: RICKY
MiddleName: L
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 68 S SERVICE RD
Address2: SUITE 350
City: MELVILLE
State: NY
PostalCode: 117472358
CountryCode: US
TelephoneNumber: 5169453107
FaxNumber: 5169453131
Practice Location
Address1: 3600 JOSEPH SIEWICK DR
Address2:  
City: FAIRFAX
State: VA
PostalCode: 220331709
CountryCode: US
TelephoneNumber: 7032959360
FaxNumber: 7032959369
Other Information
ProviderEnumerationDate: 09/22/2006
LastUpdateDate: 03/31/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X0101046164VAY Allopathic & Osteopathic PhysiciansAnesthesiology 
207LP2900X0101046164VAN Allopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine

ID Information
IDTypeStateIssuerDescription
05005274001VARAILROAD MEDICAREOTHER
197260398305VA MEDICAID
06412501VAANTHEMOTHER
29767301VAAMERIGROUPOTHER
49381801VANCPPOOTHER
K142-000101DCCAREFIRSTOTHER


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