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General NPI Number Information
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NPI Number | 1225223886
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Entity Type | Individual
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Provider Name | CHRISTIAN DE RAMOS VICTORIA PT
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Gender | Male
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Dates
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Enumeration Date | 09/07/2007
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Last Update Date | 04/04/2015
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Provider Practice Location Address
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Address Line | 301 SICOMAC AVE
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City | WYCKOFF
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State | NJ
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Zip | 07481-2159
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Country | US
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Telephone | 201-848-5200
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Fax |
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Provider Business Mailing Address
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Address Line | 11 MOUNTAIN RIDGE RD
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City | BLOOMINGDALE
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State | NJ
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Zip | 07403-1003
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Country | US
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Telephone | 201-790-2784
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA01255200
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License Number State | NJ
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