Provider Demographics
NPI:1164635793
Name:RAMESH, SUBHASHREE (MD)
Entity Type:Individual
Prefix:
First Name:SUBHASHREE
Middle Name:
Last Name:RAMESH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SUBHASHREE
Other - Middle Name:
Other - Last Name:KATUPUTHUR GOPINATHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2250 CHAPEL AVE W
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-2051
Mailing Address - Country:US
Mailing Address - Phone:856-482-9000
Mailing Address - Fax:856-482-1159
Practice Address - Street 1:2250 CHAPEL AVE W
Practice Address - Street 2:SUITE 100
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-2051
Practice Address - Country:US
Practice Address - Phone:856-482-9000
Practice Address - Fax:856-482-1159
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA087184002084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0307424Medicaid
NJ0307424Medicaid