Basic Information
Provider Information
NPI: 1043490154
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAMSEY
FirstName: KATRIN
MiddleName: L
NamePrefix: DR.
NameSuffix:  
Credential: DSC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4175 VETERANS MEMORIAL HWY
Address2: SUITE 202
City: RONKONKOMA
State: NY
PostalCode: 117797639
CountryCode: US
TelephoneNumber: 6315805200
FaxNumber: 6315805222
Practice Location
Address1: 795 FRANKLIN AVE
Address2: FRANKLIN LAKES PHYSICAL THERAPY
City: FRANKLIN LAKES
State: NJ
PostalCode: 074171368
CountryCode: US
TelephoneNumber: 2018478585
FaxNumber: 2018470985
Other Information
ProviderEnumerationDate: 11/06/2007
LastUpdateDate: 08/07/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X40QA00336800NJY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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