Provider Demographics
NPI:1063507804
Name:RAMJATTAN, SHARON (PA)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:RAMJATTAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 THEALL RD
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-1404
Mailing Address - Country:US
Mailing Address - Phone:914-848-8000
Mailing Address - Fax:914-848-8751
Practice Address - Street 1:1 THEALL RD
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-1404
Practice Address - Country:US
Practice Address - Phone:914-848-8000
Practice Address - Fax:914-848-8751
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010308-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03061727Medicaid
NY010308-1OtherPA LICENSE