Healthcare Provider Details

I. General information

NPI: 1003046384
Provider Name (Legal Business Name): SIVAPRIYA RAMAKRISHNAN M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2009
Last Update Date: 11/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1628 NORTH ALVERNON WAY TUCSON CENTRAL PEDIATRICS
TUCSON AZ
85712
US

IV. Provider business mailing address

6362 E CALLE CAVILLO
TUCSON AZ
85750-1262
US

V. Phone/Fax

Practice location:
  • Phone: 520-325-8000
  • Fax:
Mailing address:
  • Phone: 520-917-7045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101244102
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: