Provider Demographics
NPI:1134550783
Name:RAMIREZ ZUCCO, MARLODY
Entity type:Individual
Prefix:MRS
First Name:MARLODY
Middle Name:
Last Name:RAMIREZ ZUCCO
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 1:8894 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-5804
Mailing Address - Country:US
Mailing Address - Phone:718-232-1403
Mailing Address - Fax:718-232-1403
Practice Address - Street 1:1630 E 15TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1192
Practice Address - Country:US
Practice Address - Phone:646-734-5039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-09
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015687-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist