Provider Demographics
NPI:1760554406
Name:JAIPAUL RAMKELAWAN MEDICAL,P.C
Entity Type:Organization
Organization Name:JAIPAUL RAMKELAWAN MEDICAL,P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAIPAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMKELAWAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-505-2739
Mailing Address - Street 1:465 COAKLEY ST
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-3812
Mailing Address - Country:US
Mailing Address - Phone:516-505-2739
Mailing Address - Fax:
Practice Address - Street 1:11714 ROCKAWAY BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11420-1927
Practice Address - Country:US
Practice Address - Phone:718-848-0411
Practice Address - Fax:718-848-0811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY216400207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY216400OtherLICENSE#
NY02411856Medicaid
NY02411856Medicaid
NYH07593Medicare UPIN