Provider Demographics
NPI:1760054746
Name:RAMACHANDRAN, JACLYN (PA)
Entity Type:Individual
Prefix:MRS
First Name:JACLYN
Middle Name:
Last Name:RAMACHANDRAN
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:530 1ST AVE # HCC4G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6402
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:240 E 38TH ST FL 23
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2708
Practice Address - Country:US
Practice Address - Phone:212-263-3095
Practice Address - Fax:212-263-3096
Is Sole Proprietor?:No
Enumeration Date:2021-07-11
Last Update Date:2023-02-15
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant