=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245422690
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RAMAN KAUL, PHYSICIAN, P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/09/2007
-----------------------------------------------------
Last Update Date | 03/17/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7 MILLER RD
-----------------------------------------------------
City | MAHOPAC
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10541-2219
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-628-8600
-----------------------------------------------------
Fax | 845-628-8931
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 130 N MAIN ST
-----------------------------------------------------
City | NEW CITY
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10956-3821
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-639-6915
-----------------------------------------------------
Fax | 845-634-0410
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | MS. GLORIA CASTRO
-----------------------------------------------------
Credential | MEDICAL ASSISTANT
-----------------------------------------------------
Telephone | 845-639-6915
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 305R00000X
-----------------------------------------------------
Taxonomy Name | Preferred Provider Organization
-----------------------------------------------------
License Number | 1315431
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------