MEDICARE: RAMON ABAD

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	031964

General Provider Information

NPI Number	:	1194219303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAMON ABAD

Provider Business Mailing Address
First Line	:	6642 MYRTLE AVE
Second Line	:
City	:	GLENDALE
State	:	NY
Zip	:	11385-7057
Country	:	US
Telephone Number	:	718-386-7000
Fax Number	:	718-456-7585

Provider Business Practice Location Address
First Line	:	6642 MYRTLE AVE
Second Line	:
City	:	GLENDALE
State	:	NY
Zip	:	11385-7057
Country	:	US
Telephone Number	:	718-386-7000
Fax Number	:

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

Provider Enumeration Date	:	06/20/2018
Last Update Date	:	06/20/2018

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Directions to “ RAMON ABAD ” Practice Location

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