Provider Demographics
NPI:1477068500
Name:RAMASAMY, VISHNUPRIYA
Entity Type:Individual
Prefix:
First Name:VISHNUPRIYA
Middle Name:
Last Name:RAMASAMY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 PALMER RD APT 4
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-4611
Mailing Address - Country:US
Mailing Address - Phone:704-441-2408
Mailing Address - Fax:
Practice Address - Street 1:12021 LIVINGSTON RD
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-4210
Practice Address - Country:US
Practice Address - Phone:301-292-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-12
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1287505225100000X
MD26724225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist