Provider Demographics
NPI:1194725507
Name:RAMANI, VENKAT (MD)
Entity type:Individual
Prefix:DR
First Name:VENKAT
Middle Name:
Last Name:RAMANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 BRADHURST AVE STE 3100N
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-2140
Mailing Address - Country:US
Mailing Address - Phone:914-909-9018
Mailing Address - Fax:914-909-9028
Practice Address - Street 1:19 BRADHURST AVE
Practice Address - Street 2:SUITE 2850
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-2140
Practice Address - Country:US
Practice Address - Phone:914-345-1313
Practice Address - Fax:914-345-5004
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY111521-12084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00930649Medicaid
NY130023387OtherRAILROAD MEDICARE
NYA400203735OtherMEDICARE APS
A94618Medicare UPIN
88E871Medicare ID - Type Unspecified