Healthcare Provider Details

I. General information

NPI: 1346209889
Provider Name (Legal Business Name): RAMAN KANSAL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2006
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 TOWNSHIP LINE ROAD SUITE 150
YARDLEY PA
19067-5567
US

IV. Provider business mailing address

777 TOWNSHIP LINE ROAD SUITE 150
YARDLEY PA
19067-5567
US

V. Phone/Fax

Practice location:
  • Phone: 215-860-3360
  • Fax: 215-860-3362
Mailing address:
  • Phone: 215-860-3360
  • Fax: 215-860-3362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD496573
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD25686
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberMD25686
License Number StateOR
# 4
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD00043603
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: