Provider Demographics
NPI:1316474992
Name:K RAMKISSOON MEDICAL CARE PLLC
Entity type:Organization
Organization Name:K RAMKISSOON MEDICAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KESHWAR
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMKISSOON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-730-7248
Mailing Address - Street 1:11548 114TH PL
Mailing Address - Street 2:
Mailing Address - City:S OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11420-2301
Mailing Address - Country:US
Mailing Address - Phone:347-730-9248
Mailing Address - Fax:
Practice Address - Street 1:9613 FLATLANDS AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-3711
Practice Address - Country:US
Practice Address - Phone:347-730-9248
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-15
Last Update Date:2017-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY262143207R00000X, 207RC0000X, 207RC0001X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04579677Medicaid