Provider Demographics
NPI:1619004959
Name:SUBRAMANI, MUNIRATHINAM (MS MPHIL PHD)
Entity Type:Individual
Prefix:DR
First Name:MUNIRATHINAM
Middle Name:
Last Name:SUBRAMANI
Suffix:
Gender:M
Credentials:MS MPHIL PHD
Other - Prefix:DR
Other - First Name:MUNI
Other - Middle Name:
Other - Last Name:SUBRAMANI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MPHIL, PHD
Mailing Address - Street 1:11700 W CHARLESTON BLVD
Mailing Address - Street 2:#170-487
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-1573
Mailing Address - Country:US
Mailing Address - Phone:702-482-7361
Mailing Address - Fax:855-282-2754
Practice Address - Street 1:11700 W CHARLESTON BLVD
Practice Address - Street 2:#170-487
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89135-1573
Practice Address - Country:US
Practice Address - Phone:702-482-7361
Practice Address - Fax:855-282-2754
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
No246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist
No246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEG