Provider Demographics
NPI:1689275687
Name:RANGAMANNAR, RAMYA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RAMYA
Middle Name:
Last Name:RANGAMANNAR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 TRAVELER ST APT 1806
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2977
Mailing Address - Country:US
Mailing Address - Phone:603-548-2181
Mailing Address - Fax:
Practice Address - Street 1:26 CHESTNUT ST STE 2E
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-3600
Practice Address - Country:US
Practice Address - Phone:978-749-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent