Healthcare Provider Details

I. General information

NPI: 1306841838
Provider Name (Legal Business Name): AMI C RANANI O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 02/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 ROUTE 202
SOMERS NY
10589-3222
US

IV. Provider business mailing address

4 OLD FARM RD
AMAWALK NY
10501-1100
US

V. Phone/Fax

Practice location:
  • Phone: 914-277-5550
  • Fax: 914-277-5735
Mailing address:
  • Phone: 914-248-4654
  • Fax: 914-277-5735

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3503
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: