Provider Demographics
NPI:1164413076
Name:SUDHINDRA, RAMAKRISHNA R I (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMAKRISHNA
Middle Name:R
Last Name:SUDHINDRA
Suffix:I
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 1:1505 W SHERMAN AVENUE,
Mailing Address - Street 2:SUITE 101,
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360
Mailing Address - Country:US
Mailing Address - Phone:856-696-9550
Mailing Address - Fax:856-696-4932
Practice Address - Street 1:1505 W SHERMAN AVENUE,
Practice Address - Street 2:SUITE 101,
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360
Practice Address - Country:US
Practice Address - Phone:856-696-9550
Practice Address - Fax:856-696-4932
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-31
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2516802Medicaid
D97078Medicare UPIN
NJ180996AVEMedicare PIN