Provider Demographics
NPI:1578823118
Name:RAMAMOORTHY, SIVARANJANI (DNP, ANP-C, PMHNP-BC)
Entity Type:Individual
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First Name:SIVARANJANI
Middle Name:
Last Name:RAMAMOORTHY
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Gender:F
Credentials:DNP, ANP-C, PMHNP-BC
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Mailing Address - Street 1:99 GAZEBO LN
Mailing Address - Street 2:
Mailing Address - City:HOLTSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11742-1664
Mailing Address - Country:US
Mailing Address - Phone:631-730-7582
Mailing Address - Fax:
Practice Address - Street 1:99 GAZEBO LN
Practice Address - Street 2:
Practice Address - City:HOLTSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11742-1664
Practice Address - Country:US
Practice Address - Phone:631-730-7582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-16
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306012363LA2200X
NY403655363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health