Provider Demographics
NPI:1063509131
Name:RAMAN, BHARATHI (MD)
Entity Type:Individual
Prefix:
First Name:BHARATHI
Middle Name:
Last Name:RAMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1484 1ST AVE # 1486
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-2304
Mailing Address - Country:US
Mailing Address - Phone:212-746-0373
Mailing Address - Fax:212-746-7481
Practice Address - Street 1:1484 1ST AVE # 1486
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-2304
Practice Address - Country:US
Practice Address - Phone:212-746-7000
Practice Address - Fax:212-717-8207
Is Sole Proprietor?:No
Enumeration Date:2006-10-09
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY175119207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01205325Medicaid
NY63F881Medicare ID - Type Unspecified
NY01205325Medicaid