Healthcare Provider Details

I. General information

NPI: 1831110196
Provider Name (Legal Business Name): RAMIL VILLAMOR II PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 TREMONT AVE
EAST ORANGE NJ
07018-1023
US

IV. Provider business mailing address

305 ASPEN KNOLLS WAY
STATEN ISLAND NY
10312-6636
US

V. Phone/Fax

Practice location:
  • Phone: 973-676-1000
  • Fax:
Mailing address:
  • Phone: 718-966-0062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number021457-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: