Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 40QA01532300 | NJ |
NPI | 1194146654 |
---|---|
Provider Name | Maria Rizza Ramos |
First Address | Nutley, NJ 07110-3620 |
Second Address | Nutley, NJ 07110-3620 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2013 |
Last Update Date | 30/12/2013 |