Provider Demographics
NPI:1104263581
Name:RAMIREZ, JOVAN ANTONIO (DPT)
Entity type:Individual
Prefix:DR
First Name:JOVAN
Middle Name:ANTONIO
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 LAUREL PL
Mailing Address - Street 2:APT 3H
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-3662
Mailing Address - Country:US
Mailing Address - Phone:718-753-2560
Mailing Address - Fax:
Practice Address - Street 1:38 LAUREL PL
Practice Address - Street 2:APT 3H
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-3662
Practice Address - Country:US
Practice Address - Phone:718-753-2560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-27
Last Update Date:2019-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035085-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist