Provider Demographics
NPI:1538112453
Name:RAMAN, SIVA (MD)
Entity Type:Individual
Prefix:DR
First Name:SIVA
Middle Name:
Last Name:RAMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SIVARAMAN
Other - Middle Name:
Other - Last Name:SUNDARAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:80 MARCUS DRIVE
Mailing Address - Street 2:JAMAICA HOSPITAL EMERGENCY DEPT
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747
Mailing Address - Country:US
Mailing Address - Phone:631-391-7700
Mailing Address - Fax:631-454-4161
Practice Address - Street 1:8900 VAN WYCK EXPY
Practice Address - Street 2:JAMAICA HOSPITAL
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11418-2897
Practice Address - Country:US
Practice Address - Phone:718-206-8918
Practice Address - Fax:631-454-4161
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY140462207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01704049Medicaid
NY01704049Medicaid
NY6505HDMedicare ID - Type Unspecified