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General NPI Number Information
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NPI Number | 1982328217
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Entity Type | Individual
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Provider Name | JOCABED CARABALLO RAMIREZ
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Gender | Female
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Dates
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Enumeration Date | 09/29/2022
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 524 E MAIN ST STE 200
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City | RIVERHEAD
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State | NY
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Zip | 11901-2668
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Country | US
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Telephone | 631-538-0579
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Fax |
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Provider Business Mailing Address
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Address Line | 1570 WADING RIVER MANOR RD UNIT 10
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City | WADING RIVER
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State | NY
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Zip | 11792-2169
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Country | US
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Telephone | 631-939-9577
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 034251
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License Number State | NY
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