Provider Demographics
NPI:1124001870
Name:RAMISCAL, LAWRENCE SEGUI (PT,DPT,OCS,FAAOMPT)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:SEGUI
Last Name:RAMISCAL
Suffix:
Gender:M
Credentials:PT,DPT,OCS,FAAOMPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 WOODSTONE LN
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-4333
Mailing Address - Country:US
Mailing Address - Phone:609-721-1492
Mailing Address - Fax:609-227-4423
Practice Address - Street 1:11 CADILLAC RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-4815
Practice Address - Country:US
Practice Address - Phone:609-880-0880
Practice Address - Fax:609-227-4423
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-28
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA009432002251X0800X
NJ2251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ097579UY9Medicare PIN