Provider Demographics
NPI:1043557648
Name:MARIMAT, ROMEO
Entity type:Individual
Prefix:
First Name:ROMEO
Middle Name:
Last Name:MARIMAT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 RIDGE HILL BLVD UNIT 5J
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-7716
Mailing Address - Country:US
Mailing Address - Phone:917-756-6777
Mailing Address - Fax:
Practice Address - Street 1:701 RIDGE HILL BLVD UNIT 5J
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-7716
Practice Address - Country:US
Practice Address - Phone:917-756-6777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-16
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035515225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist