Provider Demographics
NPI:1003010406
Name:RAMASWAMY, RAVISHANKAR (MD, MS)
Entity Type:Individual
Prefix:DR
First Name:RAVISHANKAR
Middle Name:
Last Name:RAMASWAMY
Suffix:
Gender:M
Credentials:MD, MS
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Other - Middle Name:
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Mailing Address - Street 1:1 GUSTAVE L LEVY PL
Mailing Address - Street 2:BOX 1070
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6500
Mailing Address - Country:US
Mailing Address - Phone:212-659-8552
Mailing Address - Fax:212-860-9737
Practice Address - Street 1:1440 MADISON AVENUE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6500
Practice Address - Country:US
Practice Address - Phone:212-659-8552
Practice Address - Fax:212-860-9737
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004036-1207RG0300X
NY275411207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03474095Medicaid
NY03474095Medicaid