Provider Demographics
NPI:1740272459
Name:SOOD, RAMAN (MD)
Entity type:Individual
Prefix:DR
First Name:RAMAN
Middle Name:
Last Name:SOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:NY
Mailing Address - Zip Code:14048-2529
Mailing Address - Country:US
Mailing Address - Phone:716-366-1223
Mailing Address - Fax:716-366-6844
Practice Address - Street 1:617 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:NY
Practice Address - Zip Code:14048-2529
Practice Address - Country:US
Practice Address - Phone:716-366-1223
Practice Address - Fax:716-366-6844
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-18
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY219466-1207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00010308301OtherUNIVERA PIN NUMBER
NY000524833001OtherBLUE CROSS PIN NUMBER
NY01771695Medicaid
NY2709307OtherINDEPENDENT HEALTH PIN NU
NY000524833001OtherBLUE CROSS PIN NUMBER
NY01771695Medicaid