Provider Demographics
NPI:1467727339
Name:RAMPULLA, PHYLLIS (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:PHYLLIS
Middle Name:
Last Name:RAMPULLA
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 E 80TH ST
Mailing Address - Street 2:APT. 6A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0665
Mailing Address - Country:US
Mailing Address - Phone:646-599-3536
Mailing Address - Fax:
Practice Address - Street 1:325 E 80TH ST
Practice Address - Street 2:APT. 6A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0665
Practice Address - Country:US
Practice Address - Phone:646-599-3536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-12
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013756-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist