Healthcare Provider Details

I. General information

NPI: 1003818139
Provider Name (Legal Business Name): ASHOK KUMAR RAM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 ROCKAWAY AVE
VALLEY STREAM NY
11581-2015
US

IV. Provider business mailing address

801 ROCKAWAY AVE
VALLEY STREAM NY
11581-2015
US

V. Phone/Fax

Practice location:
  • Phone: 516-825-4151
  • Fax: 516-825-4146
Mailing address:
  • Phone: 516-825-4151
  • Fax: 516-825-4146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number139341
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: