Provider Demographics
NPI:1023023504
Name:RAMAHI, TARIK M (MD)
Entity Type:Individual
Prefix:
First Name:TARIK
Middle Name:M
Last Name:RAMAHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 PROSPECT ST
Mailing Address - Street 2:APT 3F
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-2124
Mailing Address - Country:US
Mailing Address - Phone:203-624-5622
Mailing Address - Fax:
Practice Address - Street 1:500 PROSPECT ST
Practice Address - Street 2:APT 3F
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-2124
Practice Address - Country:US
Practice Address - Phone:203-624-5622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2005-0860207RC0000X
LAMD.13810R207RC0000X
IA36416207RC0000X
NH12354207RC0000X
SC22820207RC0000X
NJ25MA07178200207RC0000X
CT030077207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
E54790Medicare UPIN