Organization Active NPI

Ramapo Medical, P.C.

  • Internal Medicine Physician
  • Suffern, NY
National Provider Identifier
1013094747
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
194890 Issued in NY
Legal business name
RAMAPO MEDICAL, P.C.
Practice address
2 Executive Blvd
Suite 404
Suffern, NY 10901-4164
Phone
(845) 357-6444
Fax
(845) 357-0179
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jeffrey S Kaminetzky, M.D.
Title
Physician
Phone
(845) 357-6444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 194890 NY Primary

Addresses

Primary practice location

2 Executive Blvd
Suite 404
Suffern, NY 10901-4164

Mailing address

2 Executive Blvd
Suite 404
Suffern, NY 10901-4164
Phone (845) 357-6444

Other identifiers 1

IdentifierTypeStateIssuer
01616788MedicaidNY

National Provider Directory

National Provider Directory

Locations

2 Executive Blvd
Ste 404
Suffern, NY 10901
Phone (845) 357-6444

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013094747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 EXECUTIVE BLVD",
            "address_2": "SUITE 404",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109014164",
            "telephone_number": "845-357-6444",
            "fax_number": "845-357-0179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 EXECUTIVE BLVD",
            "address_2": "SUITE 404",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109014164",
            "telephone_number": "845-357-6444",
            "fax_number": "845-357-0179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAMAPO MEDICAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KAMINETZKY",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "845-357-6444",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "194890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01616788",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffern, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.