Provider Demographics
NPI:1811169352
Name:RAMAKRISHNAN, PANKAJAVALLI (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:PANKAJAVALLI
Middle Name:
Last Name:RAMAKRISHNAN
Suffix:
Gender:
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 BAKER AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-1385
Mailing Address - Country:US
Mailing Address - Phone:845-483-5951
Mailing Address - Fax:
Practice Address - Street 1:19 BAKER AVE STE 301
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1385
Practice Address - Country:US
Practice Address - Phone:845-483-5951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-25
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3266702084V0102X, 2084N0400X
VA01012592552084N0400X, 2084V0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology