Healthcare Provider Details

I. General information

NPI: 1285694794
Provider Name (Legal Business Name): KUMARASWAMY KAMMARDI RAMASWAMY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: KUMAR K RAMASWAMY MD

II. Dates (important events)

Enumeration Date: 03/27/2006
Last Update Date: 12/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 MOUNTAIN BLVD
WATCHUNG NJ
07069
US

IV. Provider business mailing address

1 DOYLE CT
HILLSBOROUGH NJ
08844-4092
US

V. Phone/Fax

Practice location:
  • Phone: 908-757-1000
  • Fax: 908-757-0564
Mailing address:
  • Phone: 908-757-1000
  • Fax: 908-757-0564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMA07607900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: