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General NPI Number Information
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NPI Number | 1861554164
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Entity Type | Individual
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Provider Name | SURUJPAUL RAGNAUTH MD
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Gender | Male
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 04/28/2023
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Provider Practice Location Address
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Address Line | 11302 107TH AVE
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City | SOUTH RICHMOND HILL
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State | NY
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Zip | 11419-2502
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Country | US
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Telephone | 347-537-9391
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Fax | 718-843-5093
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Provider Business Mailing Address
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Address Line | PO BOX 30230
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City | HARTFORD
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State | CT
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Zip | 06150-0230
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Country | US
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Telephone | 800-376-5566
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 182575
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License Number State | NY
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