Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 193843-1 | NY |
Y | 2080P0201X | Pediatric Allergist | 193843 | NY |
NPI | 1568414357 |
---|---|
Provider Name | Dr. Sujatha Ramesh |
First Address | Amherst, NY 14226-3822 |
Second Address | Buffalo, NY 14222-2006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 26/12/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00010144001 | UNIVERA (01) | |
000524353001 | BC/BS (01) | |
0016957900001 | (05) | PA |
01576190 | (05) | NY |
0207422 | IHA (01) | |
040426000750 | FIDELIS (01) | |
193843-1 | MEDICAL LICENSE (01) | NY |
G05683 | (02) | |
H14835 | (02) | NY |