Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 275411 | NY |
N | 207RG0300X | Geriatric Medicine | 004036-1 | NY |
NPI | 1003010406 |
---|---|
Provider Name | Dr. Ravishankar Ramaswamy |
First Address | New York, NY 10029-6500 |
Second Address | New York, NY 10029-6500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2007 |
Last Update Date | 27/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03474095 | (05) | NY |