Provider Demographics
NPI:1104816685
Name:RAMPERSAUD, PRETAM GANESH (MD)
Entity type:Individual
Prefix:DR
First Name:PRETAM
Middle Name:GANESH
Last Name:RAMPERSAUD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:301 BUEL AVE
Mailing Address - Street 2:SIDE ENTRANCE
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-2201
Mailing Address - Country:US
Mailing Address - Phone:718-980-9898
Mailing Address - Fax:718-980-9897
Practice Address - Street 1:705 86TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-3232
Practice Address - Country:US
Practice Address - Phone:718-980-9898
Practice Address - Fax:718-980-9897
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60210256207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
2499303OtherGHI
059AKOtherEMPIRE BC/BS
3C3783OtherHEALTHNET
2180918OtherUHC
75181319OtherAETNA
NY02318436Medicaid
P2548888OtherOXFORD
144425OtherHIP
2499303OtherGHI
3C3783OtherHEALTHNET