Provider Demographics
NPI:1386692788
Name:MADHO, RAMPERSAUD (CPO)
Entity type:Individual
Prefix:
First Name:RAMPERSAUD
Middle Name:
Last Name:MADHO
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 NOTT STREET
Mailing Address - Street 2:MEDICAL ARTS BLDG STE 306
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308
Mailing Address - Country:US
Mailing Address - Phone:518-377-6080
Mailing Address - Fax:518-377-9490
Practice Address - Street 1:1201 NOTT ST
Practice Address - Street 2:MEDICAL ARTS BLDG STE 306
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-2589
Practice Address - Country:US
Practice Address - Phone:518-377-6080
Practice Address - Fax:518-377-9490
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5434600001Medicare PIN