Provider Demographics
NPI:1689781403
Name:TARABISHY, RAMSEY (MD)
Entity Type:Individual
Prefix:
First Name:RAMSEY
Middle Name:
Last Name:TARABISHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 ACADEMY HILL RD
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06374-1600
Mailing Address - Country:US
Mailing Address - Phone:860-564-4555
Mailing Address - Fax:860-564-4611
Practice Address - Street 1:50 ACADEMY HILL RD
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:CT
Practice Address - Zip Code:06374-1600
Practice Address - Country:US
Practice Address - Phone:860-564-4555
Practice Address - Fax:860-564-4611
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT026332207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001263326Medicaid
CT0V5491OtherHEALTH NET OF NE
CT010026332CT02OtherANTHEM BCBS
CT001263326Medicaid
CT0V5491OtherHEALTH NET OF NE