Healthcare Provider Details

I. General information

NPI: 1710958749
Provider Name (Legal Business Name): JANET RAMAN NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25412 73RD RD
GLEN OAKS NY
11004-1156
US

IV. Provider business mailing address

25412 73RD RD
GLEN OAKS NY
11004-1156
US

V. Phone/Fax

Practice location:
  • Phone: 718-343-5470
  • Fax: 718-831-9234
Mailing address:
  • Phone: 718-343-5470
  • Fax: 718-831-9234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF3004008-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: