Provider Demographics
NPI:1942455001
Name:MAURICIO, RUTH RAMOS (MS PT)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:RAMOS
Last Name:MAURICIO
Suffix:
Gender:F
Credentials:MS PT
Other - Prefix:
Other - First Name:RUTH LEAH
Other - Middle Name:RAMOS
Other - Last Name:MAURICIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS,PT
Mailing Address - Street 1:PO BOX 11519
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96721-6519
Mailing Address - Country:US
Mailing Address - Phone:914-882-8150
Mailing Address - Fax:
Practice Address - Street 1:2039A WAIANUENUE AVE OFC
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-1261
Practice Address - Country:US
Practice Address - Phone:808-315-7173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-17
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY62012811225100000X
HIPT-3057225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist