Provider Demographics
NPI:1003928953
Name:RAM, PADMA (MD)
Entity Type:Individual
Prefix:
First Name:PADMA
Middle Name:
Last Name:RAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 STATE ROUTE 104
Mailing Address - Street 2:SUITE 1
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-2956
Mailing Address - Country:US
Mailing Address - Phone:315-342-0030
Mailing Address - Fax:315-216-6669
Practice Address - Street 1:300 STATE ROUTE 104
Practice Address - Street 2:SUITE 1
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-2956
Practice Address - Country:US
Practice Address - Phone:315-342-0030
Practice Address - Fax:315-216-6669
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY164385-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E43939Medicare UPIN
AA0901Medicare ID - Type Unspecified