Provider Demographics
NPI: | 1467577940 |
---|---|
Name: | RAMALINGAM, MUTHULAKSHMI (MD) |
Entity Type: | Individual |
Prefix: | DR |
First Name: | MUTHULAKSHMI |
Middle Name: | |
Last Name: | RAMALINGAM |
Suffix: | |
Gender: | F |
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: | 133 FRANKLIN CORNER RD |
Mailing Address - Street 2: | |
Mailing Address - City: | LAWRENCEVILLE |
Mailing Address - State: | NJ |
Mailing Address - Zip Code: | 08648-2531 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 609-815-7270 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 133 FRANKLIN CORNER RD |
Practice Address - Street 2: | |
Practice Address - City: | LAWRENCEVILLE |
Practice Address - State: | NJ |
Practice Address - Zip Code: | 08648 |
Practice Address - Country: | US |
Practice Address - Phone: | 609-815-7270 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2007-03-21 |
Last Update Date: | 2023-06-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NJ | 25MAO5272700 | 207RE0101X, 207R00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | |
No | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NJ | 0471208 | Medicaid | |
NJ | E52217 | Medicare UPIN | |
NJ | 0471208 | Medicaid |