Provider Demographics
NPI:1750523379
Name:RAMASWAMY, PREETHI VENUGOPAL (MD)
Entity type:Individual
Prefix:MS
First Name:PREETHI
Middle Name:VENUGOPAL
Last Name:RAMASWAMY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:201 NEW JERSEY 17
Mailing Address - Street 2:11TH FLOOR
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070
Mailing Address - Country:US
Mailing Address - Phone:201-623-9438
Mailing Address - Fax:201-623-2999
Practice Address - Street 1:201 NEW JERSEY 17
Practice Address - Street 2:11TH FLOOR
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070
Practice Address - Country:US
Practice Address - Phone:201-623-9438
Practice Address - Fax:201-623-2999
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-27
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09032700207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology