Healthcare Provider Details

I. General information

NPI: 1184889032
Provider Name (Legal Business Name): NARAYAN RONUR LAKSHMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2008
Last Update Date: 01/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2022 CRESCENT ST APT 3C
ASTORIA NY
11105-3256
US

IV. Provider business mailing address

2022 CRESCENT ST APT 3C
ASTORIA NY
11105-3256
US

V. Phone/Fax

Practice location:
  • Phone: 347-803-0220
  • Fax:
Mailing address:
  • Phone: 347-803-0220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number249332
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207LA0401X
TaxonomyAddiction Medicine (Anesthesiology) Physician
License Number249332
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number249332
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number249332
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: