Healthcare Provider Details

I. General information

NPI: 1255338018
Provider Name (Legal Business Name): ONEIDA MEDICAL ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 10/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 SENECA ST
ONEIDA NY
13421-2668
US

IV. Provider business mailing address

600 SENECA ST
ONEIDA NY
13421-2668
US

V. Phone/Fax

Practice location:
  • Phone: 315-363-1345
  • Fax: 315-363-9243
Mailing address:
  • Phone: 315-363-1345
  • Fax: 315-363-9243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number249242
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number197066
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number207468
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number208658
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number251577
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number263623
License Number StateNY
# 7
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number207468
License Number StateNY

VIII. Authorized Official

Name: DANIEL M RATNARAJAH
Title or Position: OFFICER
Credential: MD
Phone: 315-363-1345