Provider Demographics
NPI:1578753406
Name:ABALOS, REY RAMOS (PT)
Entity Type:Individual
Prefix:
First Name:REY
Middle Name:RAMOS
Last Name:ABALOS
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 1:25 TOMAR CT
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-4014
Mailing Address - Country:US
Mailing Address - Phone:551-998-9675
Mailing Address - Fax:
Practice Address - Street 1:25 TOMAR CT
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-4014
Practice Address - Country:US
Practice Address - Phone:551-998-9675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01198000225100000X
NJ4OQA01198000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist