Provider Demographics
NPI:1144368200
Name:RAMOS, ABAYOMI (PT)
Entity type:Individual
Prefix:
First Name:ABAYOMI
Middle Name:
Last Name:RAMOS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1145 BORDENTOWN AVE
Mailing Address - Street 2:SUITE 16
Mailing Address - City:PARLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08859-1851
Mailing Address - Country:US
Mailing Address - Phone:732-553-1212
Mailing Address - Fax:732-553-0055
Practice Address - Street 1:1145 BORDENTOWN AVE
Practice Address - Street 2:SUITE 16
Practice Address - City:PARLIN
Practice Address - State:NJ
Practice Address - Zip Code:08859-1851
Practice Address - Country:US
Practice Address - Phone:732-553-1212
Practice Address - Fax:732-553-0055
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA06787225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ038190Medicare ID - Type UnspecifiedP.T OUTPATIENT