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General NPI Number Information
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NPI Number | 1023214160
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Entity Type | Individual
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Provider Name | GAITHRI RAMANATHAN O.D.
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Gender | Female
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Dates
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Enumeration Date | 06/25/2007
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Last Update Date | 05/13/2024
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Provider Practice Location Address
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Address Line | 610 CROSS KEYS RD STE 203
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City | SICKLERVILLE
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State | NJ
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Zip | 08081-9580
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Country | US
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Telephone | 856-250-1515
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Fax | 856-249-9118
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Provider Business Mailing Address
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Address Line | 610 CROSS KEYS RD STE 203
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City | SICKLERVILLE
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State | NJ
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Zip | 08081-9580
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Country | US
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Telephone | 856-250-1515
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Fax | 856-249-9118
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 13652
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00610001
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License Number State | NJ
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