Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 238263 | NY |
N | 2081P2900X | Pain Medicine | 238263 | NY |
N | 2081S0010X | Sports Medicine | 238263 | NY |
N | 213ES0000X | Sports Medicine | 238263 | NY |
NPI | 1194796821 |
---|---|
Provider Name | Dr. Muthu M Ramasamy |
First Address | Cooperstown, NY 13326-1301 |
Second Address | Cooperstown, NY 13326-1394 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2006 |
Last Update Date | 25/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
189053 | BLUE CROSS (01) | |
206000622 | (05) | MO |
H76723 | (02) | MO |