Provider Demographics
NPI:1588097489
Name:RAMUS, HALEY E (DPT, ATC)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:E
Last Name:RAMUS
Suffix:
Gender:F
Credentials:DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 368
Mailing Address - Street 2:
Mailing Address - City:YORK BEACH
Mailing Address - State:ME
Mailing Address - Zip Code:03910-0368
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:75 US ROUTE 1 BYP
Practice Address - Street 2:
Practice Address - City:KITTERY
Practice Address - State:ME
Practice Address - Zip Code:03904-1784
Practice Address - Country:US
Practice Address - Phone:207-475-1160
Practice Address - Fax:207-475-1194
Is Sole Proprietor?:No
Enumeration Date:2013-08-14
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH4177225100000X
ME225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1538144662Medicaid
ME1538144662OtherN/A