Healthcare Provider Details

I. General information

NPI: 1114547064
Provider Name (Legal Business Name): LOTUS CARDIOVASCULAR CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2020
Last Update Date: 04/21/2020
Certification Date: 04/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

198 OAKLEY AVE
ELMONT NY
11003-2520
US

IV. Provider business mailing address

198 OAKLEY AVE
ELMONT NY
11003-2520
US

V. Phone/Fax

Practice location:
  • Phone: 718-332-5009
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KESHWAR RAMKISSOON
Title or Position: CEO
Credential: MD
Phone: 718-332-5009