Provider Demographics
NPI:1780624577
Name:RATNAKARAM, RAMAKRISHNA (MD)
Entity type:Individual
Prefix:DR
First Name:RAMAKRISHNA
Middle Name:
Last Name:RATNAKARAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RAMAKRISHNA
Other - Middle Name:LVA
Other - Last Name:RATNAKARAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6637 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5974
Mailing Address - Country:US
Mailing Address - Phone:716-632-1595
Mailing Address - Fax:716-204-4895
Practice Address - Street 1:6637 MAIN ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5974
Practice Address - Country:US
Practice Address - Phone:716-632-1595
Practice Address - Fax:716-204-4895
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY257002207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03235325Medicaid
NY03235325Medicaid