Provider Demographics
NPI:1841835220
Name:RUIZ RAMOS, LUZ STELLA (LICENCE PT)
Entity type:Individual
Prefix:
First Name:LUZ
Middle Name:STELLA
Last Name:RUIZ RAMOS
Suffix:
Gender:F
Credentials:LICENCE PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 LIVINGSTON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-5127
Mailing Address - Country:US
Mailing Address - Phone:718-625-9911
Mailing Address - Fax:
Practice Address - Street 1:100 LIVINGSTON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5127
Practice Address - Country:US
Practice Address - Phone:718-625-9911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-09
Last Update Date:2019-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013317225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist