Provider Demographics
NPI:1255338018
Name:ONEIDA MEDICAL ASSOCIATES PLLC
Entity type:Organization
Organization Name:ONEIDA MEDICAL ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:RATNARAJAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-363-1345
Mailing Address - Street 1:600 SENECA ST
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:NY
Mailing Address - Zip Code:13421-2668
Mailing Address - Country:US
Mailing Address - Phone:315-363-1345
Mailing Address - Fax:315-363-9243
Practice Address - Street 1:600 SENECA ST
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421-2668
Practice Address - Country:US
Practice Address - Phone:315-363-1345
Practice Address - Fax:315-363-9243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207468207R00000X, 207RR0500X
NY208658207R00000X
NY249242207Q00000X
NY251577207R00000X
NY263623207R00000X
NY197066207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF96797Medicare UPIN
NYAA0188Medicare PIN
NYG31490Medicare UPIN
NYG52543Medicare UPIN
NYJ00000440Medicare PIN