Provider Demographics
NPI:1710071337
Name:RAMAN, NELLEPELLY K (MD)
Entity Type:Individual
Prefix:DR
First Name:NELLEPELLY
Middle Name:K
Last Name:RAMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:30 EAST SUNRISE HIGHWAY
Mailing Address - Street 2:SUITE 108
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581
Mailing Address - Country:US
Mailing Address - Phone:516-791-5804
Mailing Address - Fax:516-791-5809
Practice Address - Street 1:30 EAST SUNRISE HIGHWAY
Practice Address - Street 2:SUITE 108
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11581
Practice Address - Country:US
Practice Address - Phone:516-791-5804
Practice Address - Fax:516-791-5809
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY171751207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01040495Medicaid
E44686Medicare UPIN
34F001Medicare PIN
NYE44686Medicare UPIN