Provider Demographics
NPI:1518948322
Name:RAMOS, AIKO LOREN MOLERA (DPT)
Entity Type:Individual
Prefix:DR
First Name:AIKO LOREN
Middle Name:MOLERA
Last Name:RAMOS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2611 SHORE PKWY
Mailing Address - Street 2:APT. 3
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-6526
Mailing Address - Country:US
Mailing Address - Phone:646-667-8201
Mailing Address - Fax:347-713-3944
Practice Address - Street 1:2611 SHORE PKWY
Practice Address - Street 2:APT. 3
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-6526
Practice Address - Country:US
Practice Address - Phone:646-667-8201
Practice Address - Fax:347-713-3944
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020076225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00045Medicare UPIN
NYQA1651Medicare ID - Type Unspecified