Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 039703 | NY |
NPI | 1083206080 |
---|---|
Provider Name | Dr. Garry Ramos Catolico |
First Address | Sacramento, CA 95825-7507 |
Second Address | Brooklyn, NY 11229-4552 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2021 |
Last Update Date | 10/02/2021 |