Provider Demographics
NPI:1386645133
Name:RAMPAM, VIJAYALAKSHMI (MD)
Entity Type:Individual
Prefix:DR
First Name:VIJAYALAKSHMI
Middle Name:
Last Name:RAMPAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:169 N PLANK RD
Mailing Address - Street 2:SUIT 3
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-1723
Mailing Address - Country:US
Mailing Address - Phone:845-561-1560
Mailing Address - Fax:845-561-1566
Practice Address - Street 1:169 N PLANK RD
Practice Address - Street 2:SUIT 3
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-1723
Practice Address - Country:US
Practice Address - Phone:845-561-1560
Practice Address - Fax:845-561-1566
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY232821207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI23778Medicare UPIN