Provider Demographics
NPI:1952624603
Name:SALVACION, RAY MACASIL (PT)
Entity type:Individual
Prefix:MR
First Name:RAY
Middle Name:MACASIL
Last Name:SALVACION
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 1:4153 54TH ST
Mailing Address - Street 2:APT. 1
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-4646
Mailing Address - Country:US
Mailing Address - Phone:347-614-3395
Mailing Address - Fax:
Practice Address - Street 1:9807 FOSTER AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-2113
Practice Address - Country:US
Practice Address - Phone:347-435-0203
Practice Address - Fax:347-435-0207
Is Sole Proprietor?:No
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031987225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist