Provider Demographics
NPI:1316973902
Name:RAMNANAN, TERRY (MD)
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:
Last Name:RAMNANAN
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:PO BOX 604
Mailing Address - Street 2:
Mailing Address - City:SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-0604
Mailing Address - Country:US
Mailing Address - Phone:973-839-8444
Mailing Address - Fax:973-839-8445
Practice Address - Street 1:30 W CENTURY RD
Practice Address - Street 2:STE 220
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-1421
Practice Address - Country:US
Practice Address - Phone:201-523-9909
Practice Address - Fax:201-523-9910
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-24
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04543000174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJA29794Medicare UPIN
NJ073362UCNMedicare ID - Type Unspecified