Healthcare Provider Details

I. General information

NPI: 1245732585
Provider Name (Legal Business Name): ALJAY RYAN B FIGUEROA RPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2018
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MARIANAS HEALTH BLDG BLDG STE 102 GHIYAGHI ST
SAN JOSE SAIPAN MP
96950
US

IV. Provider business mailing address

P.O BOX 10003 PMB 1341
SAIPAN MP
96950
US

V. Phone/Fax

Practice location:
  • Phone: 670-233-4646
  • Fax: 670-233-4648
Mailing address:
  • Phone: 670-233-4646
  • Fax: 670-233-4648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberJ1-0003863
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: