MEDICARE: MR. RAMON DE JESUS PT

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	40QA010032	NJ

General Provider Information

NPI Number	:	1538126321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RAMON DE JESUS PT

Provider Business Mailing Address
First Line	:	7 PARLIN DR
Second Line	:
City	:	PARLIN
State	:	NJ
Zip	:	08859-2241
Country	:	US
Telephone Number	:	732-238-8484
Fax Number	:	732-238-3031

Provider Business Practice Location Address
First Line	:	329 CULVER RD
Second Line	:
City	:	MONMOUTH JUNCTION
State	:	NJ
Zip	:	08852-2810
Country	:	US
Telephone Number	:	732-438-3736
Fax Number	:	732-438-8486

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

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	09/17/2008

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Directions to “ MR. RAMON DE JESUS PT” Practice Location

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