Healthcare Provider Details

I. General information

NPI: 1376571737
Provider Name (Legal Business Name): RAMIAH SATHANANTHAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 THOMAS INDIAN SCHOOL DRIVE CATTARAUGUS INDIAN RESERVATION HEALTH CENTER
IRVING NY
14081
US

IV. Provider business mailing address

36 THOMAS INDIAN SCHOOL DRIVE CATTARAUGUS INDIAN RESERVATION HEALTH CENTER
IRVING NY
14081
US

V. Phone/Fax

Practice location:
  • Phone: 716-532-5582
  • Fax: 716-532-0110
Mailing address:
  • Phone: 716-532-5582
  • Fax: 716-532-0110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number119850
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: