Provider Demographics
NPI:1568404275
Name:SUNDAR, RAMASWAMI P (MD)
Entity Type:Individual
Prefix:
First Name:RAMASWAMI
Middle Name:P
Last Name:SUNDAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:80 MARCUS DR
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-4230
Mailing Address - Country:US
Mailing Address - Phone:631-391-8354
Mailing Address - Fax:631-454-4163
Practice Address - Street 1:1 BROOKDALE PLAZA
Practice Address - Street 2:SNAPPER PAVILION RM 422 T J H MEDICAL SERVICES PC
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212
Practice Address - Country:US
Practice Address - Phone:718-240-5622
Practice Address - Fax:718-240-6546
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1480152084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00876013Medicaid
NY00876013Medicaid
NY38D301Medicare ID - Type Unspecified