Provider Demographics
NPI:1801970041
Name:RAMIREZ, RODNEY (PT)
Entity type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:
Last Name:RAMIREZ
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 1:8515 65TH RD
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-5035
Mailing Address - Country:US
Mailing Address - Phone:347-393-0262
Mailing Address - Fax:718-606-9516
Practice Address - Street 1:8515 65TH RD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-5035
Practice Address - Country:US
Practice Address - Phone:347-393-0262
Practice Address - Fax:718-606-9516
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022652-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY07976GMedicare PIN
NYG300090327Medicare PIN