Provider Demographics
NPI:1497910657
Name:RAMPAM, SUKHADEVAN (RPH)
Entity Type:Individual
Prefix:
First Name:SUKHADEVAN
Middle Name:
Last Name:RAMPAM
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 BROOKSIDE AVE
Mailing Address - Street 2:SUITE 122
Mailing Address - City:CHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10918-1059
Mailing Address - Country:US
Mailing Address - Phone:845-469-7859
Mailing Address - Fax:845-469-6050
Practice Address - Street 1:78 BROOKSIDE AVE
Practice Address - Street 2:SUITE 122
Practice Address - City:CHESTER
Practice Address - State:NY
Practice Address - Zip Code:10918-1059
Practice Address - Country:US
Practice Address - Phone:845-469-7859
Practice Address - Fax:845-469-6050
Is Sole Proprietor?:No
Enumeration Date:2008-07-26
Last Update Date:2008-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048626-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist