Provider Demographics
NPI:1871906073
Name:CARRION, RUBY ANN (PT)
Entity type:Individual
Prefix:
First Name:RUBY ANN
Middle Name:
Last Name:CARRION
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9960 64TH AVE APT 3P
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-2659
Mailing Address - Country:US
Mailing Address - Phone:347-301-3302
Mailing Address - Fax:
Practice Address - Street 1:9960 64TH AVE APT 3P
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2659
Practice Address - Country:US
Practice Address - Phone:347-301-3302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032441225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist