MEDICARE: DAMALI RAMDYHAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	732100	NY

General Provider Information

NPI Number	:	1043921406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAMALI RAMDYHAN

Provider Business Mailing Address
First Line	:	11522 198TH ST
Second Line	:
City	:	SAINT ALBANS
State	:	NY
Zip	:	11412-2829
Country	:	US
Telephone Number	:	917-288-5772
Fax Number	:

Provider Business Practice Location Address
First Line	:	11522 198TH ST
Second Line	:
City	:	SAINT ALBANS
State	:	NY
Zip	:	11412-2829
Country	:	US
Telephone Number	:	917-288-5772
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2022
Last Update Date	:	12/07/2022

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Directions to “ DAMALI RAMDYHAN ” Practice Location

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