MEDICARE: DR. AIKO LOREN MOLERA RAMOS DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	020076	NY

General Provider Information

NPI Number	:	1518948322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AIKO LOREN MOLERA RAMOS DPT

Provider Business Mailing Address
First Line	:	2611 SHORE PKWY
Second Line	:	APT. 3
City	:	BROOKLYN
State	:	NY
Zip	:	11223-6526
Country	:	US
Telephone Number	:	646-667-8201
Fax Number	:	347-713-3944

Provider Business Practice Location Address
First Line	:	2611 SHORE PKWY
Second Line	:	APT. 3
City	:	BROOKLYN
State	:	NY
Zip	:	11223-6526
Country	:	US
Telephone Number	:	646-667-8201
Fax Number	:	347-713-3944

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	03/13/2012

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