Healthcare Provider Details

I. General information

NPI: 1538241344
Provider Name (Legal Business Name): RANBIR S SODHI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 PARK PL
ST JOHNSVILLE NY
13452-1332
US

IV. Provider business mailing address

8 PARK PL
ST JOHNSVILLE NY
13452-1332
US

V. Phone/Fax

Practice location:
  • Phone: 518-568-5410
  • Fax: 518-568-3216
Mailing address:
  • Phone: 518-568-5410
  • Fax: 518-568-3216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number122476
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number122476
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: