Healthcare Provider Details

I. General information

NPI: 1609500578
Provider Name (Legal Business Name): ARIEL RAMAT PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ARIEL KIELE MAMIYA PTA

II. Dates (important events)

Enumeration Date: 07/14/2022
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 EDWARDS MILL RD STE 200
RALEIGH NC
27612-5243
US

IV. Provider business mailing address

3001 EDWARDS MILL RD STE 200
RALEIGH NC
27612-5243
US

V. Phone/Fax

Practice location:
  • Phone: 919-863-6856
  • Fax:
Mailing address:
  • Phone: 919-781-4060
  • Fax: 919-781-5246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberA8566
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number2169579
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: