Provider Demographics
NPI:1245422690
Name:RAMAN KAUL, PHYSICIAN, P.C.
Entity Type:Organization
Organization Name:RAMAN KAUL, PHYSICIAN, P.C.
Other - Org Name:NEW CITY RADIATION ONCOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:MEDICAL ASSISTANT
Authorized Official - Phone:845-639-6915
Mailing Address - Street 1:130 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-3821
Mailing Address - Country:US
Mailing Address - Phone:845-639-6915
Mailing Address - Fax:845-634-0410
Practice Address - Street 1:7 MILLER RD
Practice Address - Street 2:
Practice Address - City:MAHOPAC
Practice Address - State:NY
Practice Address - Zip Code:10541-2219
Practice Address - Country:US
Practice Address - Phone:845-628-8600
Practice Address - Fax:845-628-8931
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RAMAN KAUL, PHYSICIAN, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-09
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1315431305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01009310Medicaid
NY01009310Medicaid