Provider Demographics
NPI:1245456094
Name:LIGSAY, RICARTE (PT)
Entity type:Individual
Prefix:
First Name:RICARTE
Middle Name:
Last Name:LIGSAY
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 1:390 JAMES WOODS CT
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07646-1463
Mailing Address - Country:US
Mailing Address - Phone:201-261-0905
Mailing Address - Fax:201-483-8554
Practice Address - Street 1:616 CASTLE HILL AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-1402
Practice Address - Country:US
Practice Address - Phone:718-792-6000
Practice Address - Fax:718-792-6001
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011877225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02459589Medicaid
NY02459589Medicaid