1194796821 NPI number — DR. MUTHU M RAMASAMY M.D., FRCS

Table of content: DR. MUTHU M RAMASAMY M.D., FRCS (NPI 1194796821)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194796821 NPI number — DR. MUTHU M RAMASAMY M.D., FRCS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAMASAMY
Provider First Name:
MUTHU
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D., FRCS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194796821
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/25/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 ATWELL RD
Provider Second Line Business Mailing Address:
DEPARTMENT OF SURGERY, BASSETT HEALTHCARE
Provider Business Mailing Address City Name:
COOPERSTOWN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13326-1301
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
607-547-7835
Provider Business Mailing Address Fax Number:
607-547-8740

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
21 RAILROAD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COOPERSTOWN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13326-1394
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
607-547-7835
Provider Business Practice Location Address Fax Number:
607-547-8740
Provider Enumeration Date:
01/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 261QP3300X , with the licence number:  238263 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2081S0010X , with the licence number: 238263 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208100000X , with the licence number: 238263 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208VP0014X , with the licence number: 238263 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2081P2900X , with the licence number: 238263 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2081P0004X , with the licence number: 238263 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 189053 . This is a "BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 206000622 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




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