Healthcare Provider Details
I. General information
NPI: 1285713016
Provider Name (Legal Business Name): RAMAN SOOD, PHYSICIAN, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/03/2006
Last Update Date: 07/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
617 CENTRAL AVE
DUNKIRK NY
14048-2529
US
IV. Provider business mailing address
617 CENTRAL AVE
DUNKIRK NY
14048-2529
US
V. Phone/Fax
- Phone: 716-366-1223
- Fax: 716-366-6844
- Phone: 716-366-1223
- Fax: 716-366-6844
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RX0202X |
| Taxonomy | Medical Oncology Physician |
| License Number | 219466-1 |
| License Number State | NY |
VIII. Authorized Official
Name: DR.
RAMAN
SOOD
Title or Position: PHYSICAN AND OWNER
Credential: M.D.
Phone: 716-366-1223