Healthcare Provider Details

I. General information

NPI: 1558356089
Provider Name (Legal Business Name): RAMANUJAPURAM A P RAMANUJAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2005
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 MITCHELL AVE.
BINGHAMTON NY
13903-0099
US

IV. Provider business mailing address

40 MITCHELL AVE. PO BOX 99
BINGHAMTON NY
13903-0099
US

V. Phone/Fax

Practice location:
  • Phone: 607-723-1676
  • Fax: 607-772-6304
Mailing address:
  • Phone: 607-723-1676
  • Fax: 607-772-6304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number138226
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: