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General NPI Number Information
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NPI Number | 1790765576
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Entity Type | Individual
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Provider Name | KOVIL RAMASAMY M.D.,
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Gender | Male
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Dates
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Enumeration Date | 01/18/2006
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Last Update Date | 04/23/2008
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Provider Practice Location Address
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Address Line | 534 AVENUE E SUITE 1A
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City | BAYONNE
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State | NJ
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Zip | 07002-3915
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Country | US
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Telephone | 201-858-8444
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Fax | 201-858-4260
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Provider Business Mailing Address
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Address Line | 534 AVENUE E SUITE 1-A
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City | BAYONNE
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State | NJ
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Zip | 07002-3987
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Country | US
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Telephone | 201-858-8444
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Fax | 201-858-4260
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MA06946500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MA06946500
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License Number State | NJ
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