Provider Demographics
NPI:1659471308
Name:RAMOS, ERIBERTO CYRIS TAHIMIC III (PT)
Entity type:Individual
Prefix:MR
First Name:ERIBERTO CYRIS
Middle Name:TAHIMIC
Last Name:RAMOS
Suffix:III
Gender:M
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:827 CARMAN AVE
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-6429
Mailing Address - Country:US
Mailing Address - Phone:516-279-6486
Mailing Address - Fax:516-977-3512
Practice Address - Street 1:827 CARMAN AVE
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-6429
Practice Address - Country:US
Practice Address - Phone:516-279-6486
Practice Address - Fax:516-977-3512
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2010-10-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY0222562251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02949177Medicaid
NYQ00F01Medicare ID - Type UnspecifiedPHYSICAL THERAPY PROVIDER