Provider Demographics
NPI:1972562155
Name:DHAWAN, RAMAN
Entity type:Individual
Prefix:
First Name:RAMAN
Middle Name:
Last Name:DHAWAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:739 IRVING AVE
Mailing Address - Street 2:SUITE 520, CHY MEDICAL CENTER
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210
Mailing Address - Country:US
Mailing Address - Phone:315-470-1051
Mailing Address - Fax:315-470-1380
Practice Address - Street 1:739 IRVING AVE
Practice Address - Street 2:SUITE 520, CHY MEDICAL CENTER
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210
Practice Address - Country:US
Practice Address - Phone:315-470-1051
Practice Address - Fax:315-470-1380
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY234317207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P010234317OtherBLUE CHOICE
NYRB4429OtherMEDICARE ID-UNSPECIFIED
P020234317OtherROCHESTER BLUE SHIELD
I27049Medicare UPIN