Provider Demographics
NPI:1295898302
Name:RAMANATHAN, NITHYA (MD)
Entity type:Individual
Prefix:DR
First Name:NITHYA
Middle Name:
Last Name:RAMANATHAN
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 1:5190 BLAZER PKWY
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-1339
Mailing Address - Country:US
Mailing Address - Phone:614-787-2714
Mailing Address - Fax:614-389-3041
Practice Address - Street 1:5190 BLAZER PKWY
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-1339
Practice Address - Country:US
Practice Address - Phone:614-787-2714
Practice Address - Fax:614-389-3041
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350832322084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2620284Medicaid
OHBR9112955OtherDEA
OHRA4175771Medicare UPIN
OHRA4175772Medicare UPIN
OHH273870Medicare PIN
OHBR9112955OtherDEA