Provider Demographics
NPI:1356053151
Name:POSTRANO, RAMON MIRA JR
Entity type:Individual
Prefix:
First Name:RAMON
Middle Name:MIRA
Last Name:POSTRANO
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28652 NY-23 STAMFORD
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:NY
Mailing Address - Zip Code:12167
Mailing Address - Country:US
Mailing Address - Phone:607-652-7521
Mailing Address - Fax:
Practice Address - Street 1:28652 NY-23
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:NY
Practice Address - Zip Code:12167
Practice Address - Country:US
Practice Address - Phone:607-652-7521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-23
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042930225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist