Healthcare Provider Details

I. General information

NPI: 1720760366
Provider Name (Legal Business Name): ADARSH SRINIVAS RAMESH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2023
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4417 VESTAL PKWY E
VESTAL NY
13850-3556
US

IV. Provider business mailing address

4417 VESTAL PKWY E
VESTAL NY
13850-3556
US

V. Phone/Fax

Practice location:
  • Phone: 607-729-8833
  • Fax: 607-729-2984
Mailing address:
  • Phone: 607-729-8833
  • Fax: 607-729-2984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: