Provider Demographics
NPI:1194146654
Name:RAMOS, MARIA RIZZA
Entity type:Individual
Prefix:
First Name:MARIA RIZZA
Middle Name:
Last Name:RAMOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:452 RIVER RD
Mailing Address - Street 2:APT. K
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-3620
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:452 RIVER RD
Practice Address - Street 2:APT. K
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-3620
Practice Address - Country:US
Practice Address - Phone:937-654-3563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-30
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA015323002251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics