Provider Demographics
NPI:1417611906
Name:RAMOS MORALES, JOEL (APRN)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:RAMOS MORALES
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 211226
Mailing Address - Street 2:
Mailing Address - City:WOODHAVEN
Mailing Address - State:NY
Mailing Address - Zip Code:11421-6226
Mailing Address - Country:US
Mailing Address - Phone:718-805-0037
Mailing Address - Fax:866-221-0879
Practice Address - Street 1:1052 LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-2913
Practice Address - Country:US
Practice Address - Phone:718-805-0037
Practice Address - Fax:866-221-0879
Is Sole Proprietor?:No
Enumeration Date:2021-10-29
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF357158363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL917376Medicaid