MEDICARE: MRS. MARLODY RAMIREZ ZUCCO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	015687-1	NY

General Provider Information

NPI Number	:	1134550783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARLODY RAMIREZ ZUCCO

Provider Business Mailing Address
First Line	:	8894 16TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-5804
Country	:	US
Telephone Number	:	718-232-1403
Fax Number	:	718-232-1403

Provider Business Practice Location Address
First Line	:	1630 E 15TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1192
Country	:	US
Telephone Number	:	646-734-5039
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2013
Last Update Date	:	12/09/2013

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