Healthcare Provider Details

I. General information

NPI: 1184076507
Provider Name (Legal Business Name): SHAMANTHY RATNASINGAM M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2016
Last Update Date: 06/21/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 CRYSTAL RUN RD
MIDDLETOWN NY
10941-4028
US

IV. Provider business mailing address

1000 MONTAUK HWY
WEST ISLIP NY
11795-4927
US

V. Phone/Fax

Practice location:
  • Phone: 845-703-6999
  • Fax: 845-703-6297
Mailing address:
  • Phone: 631-376-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number299495
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: