Provider Demographics
NPI:1316257942
Name:RAMESH, SHRUTI CHAKRABARTI (DO)
Entity type:Individual
Prefix:DR
First Name:SHRUTI
Middle Name:CHAKRABARTI
Last Name:RAMESH
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:90 MILLBURN AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1945
Mailing Address - Country:US
Mailing Address - Phone:973-378-7990
Mailing Address - Fax:973-378-7991
Practice Address - Street 1:90 MILLBURN AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1945
Practice Address - Country:US
Practice Address - Phone:973-378-7990
Practice Address - Fax:973-378-7991
Is Sole Proprietor?:No
Enumeration Date:2010-10-17
Last Update Date:2015-07-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB08782900208000000X
NY259294208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics