Provider Demographics
NPI:1922754746
Name:RAMOS, ERLYNN MAE A (OT)
Entity Type:Individual
Prefix:
First Name:ERLYNN MAE
Middle Name:A
Last Name:RAMOS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-3229
Mailing Address - Country:US
Mailing Address - Phone:973-669-7382
Mailing Address - Fax:
Practice Address - Street 1:520 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-3229
Practice Address - Country:US
Practice Address - Phone:973-669-7382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY63-011875225X00000X
NJ46TR00420100225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist