MEDICARE: DR. RAM TIWARI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	133418	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538181730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAM TIWARI MD

Provider Business Mailing Address
First Line	:	1739 WILLIAMSBRIDGE RD
Second Line	:	BRONX
City	:	BRONX
State	:	NY
Zip	:	10461-6203
Country	:	US
Telephone Number	:	718-824-1560
Fax Number	:	718-409-5213

Provider Business Practice Location Address
First Line	:	1739 WILLIAMSBRIDGE RD
Second Line	:	BRONX
City	:	BRONX
State	:	NY
Zip	:	10461-6203
Country	:	US
Telephone Number	:	718-824-1560
Fax Number	:	718-409-5213

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	01/24/2013

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