Provider Demographics
NPI:1376748038
Name:RAMOS, EARL (PT)
Entity Type:Individual
Prefix:MR
First Name:EARL
Middle Name:
Last Name:RAMOS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3240 92ND ST APT 410B
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11369-2412
Mailing Address - Country:US
Mailing Address - Phone:917-420-1054
Mailing Address - Fax:
Practice Address - Street 1:19705 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423-2126
Practice Address - Country:US
Practice Address - Phone:718-465-4400
Practice Address - Fax:718-740-3111
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025862-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist