Provider Demographics
NPI:1053687004
Name:RAMESH, SATHYADEEPAK (MD)
Entity Type:Individual
Prefix:
First Name:SATHYADEEPAK
Middle Name:
Last Name:RAMESH
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 1:535 SYCAMORE AVE
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4224
Mailing Address - Country:US
Mailing Address - Phone:732-333-8720
Mailing Address - Fax:
Practice Address - Street 1:35 CLYDE RD STE 104
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-5045
Practice Address - Country:US
Practice Address - Phone:609-608-0142
Practice Address - Fax:855-644-0469
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-23
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD463790207WX0200X, 207W00000X
NJ25MA10790600207WX0200X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery