Healthcare Provider Details
I. General information
NPI: 1134131766
Provider Name (Legal Business Name): AMAR S. RANAWAT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/12/2006
Last Update Date: 12/30/2020
Certification Date: 12/30/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
535 E 70TH ST
NEW YORK NY
10021-4823
US
IV. Provider business mailing address
PO BOX 29234
NEW YORK NY
10087-9234
US
V. Phone/Fax
- Phone: 646-797-8713
- Fax:
- Phone: 646-797-8713
- Fax: 631-329-6951
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XS0114X |
| Taxonomy | Adult Reconstructive Orthopaedic Surgery Physician |
| License Number | 209851 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: