Provider Demographics
NPI:1922686062
Name:RUMMANEETHORN, NATCHA (MD)
Entity Type:Individual
Prefix:DR
First Name:NATCHA
Middle Name:
Last Name:RUMMANEETHORN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 CENTRAL PARK AVE APT J6
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-1331
Mailing Address - Country:US
Mailing Address - Phone:914-839-9544
Mailing Address - Fax:
Practice Address - Street 1:1901 1ST AVE # 2A31
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-7491
Practice Address - Country:US
Practice Address - Phone:914-839-9544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-30
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program