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General NPI Number Information
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NPI Number | 1669653184
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Entity Type | Individual
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Provider Name | ROY GEORGI OOMMEN MD
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Gender | Male
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Dates
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Enumeration Date | 11/27/2007
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Last Update Date | 08/05/2024
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Provider Practice Location Address
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Address Line | 1978 CROMPOND RD
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City | CORTLANDT MANOR
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State | NY
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Zip | 10567-4111
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Country | US
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Telephone | 914-293-8600
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Fax | 914-293-8606
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Provider Business Mailing Address
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Address Line | 50 DAYTON LN SUITE 202
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City | PEEKSKILL
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State | NY
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Zip | 10566-2859
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Country | US
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Telephone | 914-739-0087
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Fax | 914-737-1714
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 1563394012
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 247213
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 255950
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License Number State | NY
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