Provider Demographics
NPI:1518256296
Name:RAMIREZ, SUSANA R
Entity Type:Individual
Prefix:MS
First Name:SUSANA
Middle Name:R
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12711 WOODS AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-2825
Mailing Address - Country:US
Mailing Address - Phone:562-447-7819
Mailing Address - Fax:
Practice Address - Street 1:12711 WOODS AVE APT 4
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-2825
Practice Address - Country:US
Practice Address - Phone:562-447-7819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-01
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner