MEDICARE: RICARTE LIGSAY PT

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	011877	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245456094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICARTE LIGSAY PT

Provider Business Mailing Address
First Line	:	390 JAMES WOODS CT
Second Line	:
City	:	NEW MILFORD
State	:	NJ
Zip	:	07646-1463
Country	:	US
Telephone Number	:	201-261-0905
Fax Number	:	201-483-8554

Provider Business Practice Location Address
First Line	:	616 CASTLE HILL AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10473-1402
Country	:	US
Telephone Number	:	718-792-6000
Fax Number	:	718-792-6001

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

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	03/19/2013

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