Provider Demographics
NPI:1447779764
Name:RAMASWAMY, SUDHA (PHD, BCBA-D, LBA)
Entity Type:Individual
Prefix:DR
First Name:SUDHA
Middle Name:
Last Name:RAMASWAMY
Suffix:
Gender:F
Credentials:PHD, BCBA-D, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 5TH AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029
Mailing Address - Country:US
Mailing Address - Phone:646-450-6210
Mailing Address - Fax:
Practice Address - Street 1:1160 5TH AVE APT 104
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6932
Practice Address - Country:US
Practice Address - Phone:646-450-6210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-18
Last Update Date:2017-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000118-1103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst