Provider Demographics
NPI:1396890398
Name:RAMAN, ANASUYA A (MD)
Entity type:Individual
Prefix:DR
First Name:ANASUYA
Middle Name:A
Last Name:RAMAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:106 S PERRY ST STE 4
Mailing Address - Street 2:
Mailing Address - City:WATKINS GLEN
Mailing Address - State:NY
Mailing Address - Zip Code:14891-1615
Mailing Address - Country:US
Mailing Address - Phone:607-535-8282
Mailing Address - Fax:607-535-8284
Practice Address - Street 1:106 S PERRY ST STE 4
Practice Address - Street 2:
Practice Address - City:WATKINS GLEN
Practice Address - State:NY
Practice Address - Zip Code:14891-1615
Practice Address - Country:US
Practice Address - Phone:607-535-8282
Practice Address - Fax:607-535-8284
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1455222084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY145522-1Medicaid