Provider Demographics
NPI:1689611444
Name:ATIENZA, RAMON MELO (PT)
Entity Type:Individual
Prefix:MR
First Name:RAMON
Middle Name:MELO
Last Name:ATIENZA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1991 MARCUS AVE
Mailing Address - Street 2:STE 110
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-2062
Mailing Address - Country:US
Mailing Address - Phone:516-466-4700
Mailing Address - Fax:516-466-4810
Practice Address - Street 1:1991 MARCUS AVE
Practice Address - Street 2:STE 110
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-2062
Practice Address - Country:US
Practice Address - Phone:516-466-4700
Practice Address - Fax:516-466-4810
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY021361-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist