Provider Demographics
NPI:1821230699
Name:S. RAMACHANDRAN NAIR, MD, PC
Entity Type:Organization
Organization Name:S. RAMACHANDRAN NAIR, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:S. RAMACHANDRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NAIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PC
Authorized Official - Phone:718-727-0707
Mailing Address - Street 1:51 NIXON AVENUE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304
Mailing Address - Country:US
Mailing Address - Phone:718-727-0707
Mailing Address - Fax:718-556-3640
Practice Address - Street 1:11 RALPH PLACE
Practice Address - Street 2:STE 211
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304
Practice Address - Country:US
Practice Address - Phone:718-727-0707
Practice Address - Fax:718-556-3640
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:S. RAMACHANDRAN NAIR, MD, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-03-25
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY131614207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty