MEDICARE: PHYSICAL MEDICINE OF RAMAPO PLLC

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	208VP0000X	Pain Medicine Physician	260184	NY

General Provider Information

NPI Number	:	1962809822
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICAL MEDICINE OF RAMAPO PLLC

Provider Business Mailing Address
First Line	:	26 FIREMANS MEMORIAL DRIVE
Second Line	:	SUITE 115
City	:	POMONA
State	:	NY
Zip	:	10970
Country	:	US
Telephone Number	:	800-750-8616
Fax Number	:	845-362-8474

Provider Business Practice Location Address
First Line	:	222 ROUTE 59
Second Line	:	SUITE 106
City	:	SUFFERN
State	:	NY
Zip	:	10901-5207
Country	:	US
Telephone Number	:	845-357-9400
Fax Number	:	845-357-0316

Authorized Official
Title or Position	:	OWNER/MD
Name	:	NORMA BILBOOL
Credential	:	MD
Telephone Number	:	800-750-8616

Provider Enumeration Date	:	11/20/2014
Last Update Date	:	03/02/2016

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