Provider Demographics
NPI:1649263310
Name:NYACK MEDICAL CARE, PC
Entity type:Organization
Organization Name:NYACK MEDICAL CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KALPANA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMDAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-353-3343
Mailing Address - Street 1:169 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-3001
Mailing Address - Country:US
Mailing Address - Phone:845-353-3343
Mailing Address - Fax:845-353-3379
Practice Address - Street 1:169 MAIN ST
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-3001
Practice Address - Country:US
Practice Address - Phone:845-353-3343
Practice Address - Fax:845-353-3379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-26
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1877611207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEQ691Medicare UPIN