Provider Demographics
NPI:1215986831
Name:VISWANATHAN, RAMASWAMY (MD)
Entity type:Individual
Prefix:
First Name:RAMASWAMY
Middle Name:
Last Name:VISWANATHAN
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 1:450 CLARKSON AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2056
Mailing Address - Country:US
Mailing Address - Phone:718-270-2352
Mailing Address - Fax:718-270-3355
Practice Address - Street 1:450 CLARKSON AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2056
Practice Address - Country:US
Practice Address - Phone:718-270-2352
Practice Address - Fax:718-270-3355
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1303292084P0800X, 2084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0013680OtherGHI
NY35996OtherBLUE SHIELD
NY02365960Medicaid
NYKS589OtherOXFORD HEALTH INSURANCE
NY147581OtherVALUEOPTIONS
NY147581OtherVALUEOPTIONS
NYKS589OtherOXFORD HEALTH INSURANCE
NY02365960Medicaid