Provider Demographics
NPI:1003180134
Name:DIZON, RAMONCITO TIOSEJO (RPT)
Entity Type:Individual
Prefix:MR
First Name:RAMONCITO
Middle Name:TIOSEJO
Last Name:DIZON
Suffix:
Gender:M
Credentials:RPT
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Mailing Address - Street 1:25 TUDOR CITY PL APT 1006
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-6839
Mailing Address - Country:US
Mailing Address - Phone:212-682-8607
Mailing Address - Fax:212-682-8607
Practice Address - Street 1:1615 MADISON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-3513
Practice Address - Country:US
Practice Address - Phone:212-860-5803
Practice Address - Fax:212-860-6095
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-07
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY022007-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics