Provider Demographics
NPI:1598760944
Name:SHASTRI, RAMESH H (MD)
Entity Type:Individual
Prefix:
First Name:RAMESH
Middle Name:H
Last Name:SHASTRI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3095 HARLEM RD
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-2500
Mailing Address - Country:US
Mailing Address - Phone:716-896-8831
Mailing Address - Fax:716-896-2318
Practice Address - Street 1:1900 RIDGE RD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-3332
Practice Address - Country:US
Practice Address - Phone:716-674-5966
Practice Address - Fax:716-896-2318
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-14
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY113789207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00643201Medicaid
NYDD0637Medicare ID - Type Unspecified
NY00643201Medicaid